Cancer Management and Research (May 2020)

Prognostic Significance of the Preoperative Lymphocyte to Monocyte Ratio in Patients with Gallbladder Carcinoma

  • Xu W,
  • Wu X,
  • Wang X,
  • Yu S,
  • Xu G,
  • Xiong J,
  • Zhang J,
  • Sang X,
  • Zheng Y,
  • Liu W

Journal volume & issue
Vol. Volume 12
pp. 3271 – 3283

Abstract

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Weiyu Xu,1,* Xiaoqian Wu,2,* Xuezhu Wang,2,* Si Yu,2 Gang Xu,2 Jianping Xiong,3 Junwei Zhang,2 Xinting Sang,2 Yongchang Zheng,2 Wei Liu1 1Department of General Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China; 2Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), Beijing 100730, People’s Republic of China; 3Department of Interventional Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yongchang ZhengDepartment of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), 1 Shuaifuyuan, Wangfujing, Beijing 100730, People’s Republic of ChinaEmail [email protected] LiuDepartment of Human Anatomy, Histology and Embryology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, 9 Dongdan Santiao, Dongcheng District, Beijing 100005, People’s Republic of ChinaEmail [email protected]: This study was designed to investigate the prognostic value of the lymphocyte to monocyte ratio (LMR) in patients with gallbladder carcinoma (GBC).Patients and Methods: We retrospectively enrolled 154 consecutive GBC patients from 2005 to 2017 in this study. The LMR of preoperative blood samples was calculated by dividing the lymphocyte count by the monocyte count. A receiver operating characteristic (ROC) curve was employed to identify the optimal cut-off value of the LMR in the determination of overall survival (OS). The Kaplan–Meier method was utilized to assess OS, and the Log rank test was employed to compare survival differences. Univariate and multivariate Cox regression analyses were conducted to detect independent prognostic indicators.Results: The optimal cut-off point for the LMR was 4.76 according to the ROC curve. Patients ≤ 60 years old with an LMR ≤ 4.76 experienced significantly worse OS than those with an LMR > 4.76 (hazard ratio (HR): 0.399, 95% confidence interval (CI): 0.265– 0.602, P< 0.001); however, the prognostic value of the LMR was not determined in patients > 60 years old or among the entire study cohort (both P> 0.05). Significantly poorer OS was observed in patients > 60 years with an LMR ≤ 4.21 compared to those with an LMR > 4.21 (HR: 1.830, 95% CI: 1.129– 2.967, P=0.014). Multivariate Cox regression analysis indicated that both the high and low LMR cut-off values were independent risk factors for OS (HR: 0.272, 95% CI: 0.105– 0.704, P=0.007; HR: 0.544, 95% CI: 0.330– 0.895, P=0.017).Conclusion: The LMR is an independent prognostic indicator for GBC patients, the cut-off value of which is age dependent.Keywords: gallbladder cancer, lymphocyte to monocyte ratio, LMR, survival, prognosis, biomarker  

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