Association between monocyte-to-lymphocyte ratio and prognosis of patients with epithelial ovarian cancer

Abstract

Objective To explore the association between monocyte-to-lymphocyte ratio (MLR) and prognosis of patients with epithelial ovarian cancer (EOC). Methods A total of 214 patients with EOC who underwent initial surgical resection between January 2005 to January 2015 in Second Clinical Medical College of North Sichuan Medical College were selected as research subjects. Clinical data of all subjects were collected by retrospective analysis. The receiver operating characteristic (ROC) curve of MLR predicting overall survival (OS) time in patients with EOC was drawn. The optimal cut-off value of MLR predicting OS time in patients with EOC was determined by ROC curve, and the EOC patients were categorized into two group according to the optimal cut-off value of MLR. The clinicopathological features and OS time of the 2 groups were compared statistically. Univariate and multivariate Cox regression analysis was used to analyze the factors that might affect OS time in patients with EOC. Results ①According to the ROC curve of MLR predicting OS time in patients with EOC, the optimal cut-off value of MLR predicting OS time in patients with EOC was 0.26. Accordingly, all the 214 EOC patients were categorized into the high MLR group (n=128, MLR≥0.26) and low MLR group (n=86, MLR 0.05). ②The rates of patients with ≥62 years old, serous ovarian cancer histopathological type, Federation International of Gynecology and Obstetrics (FIGO) stage Ⅲ-Ⅳ, the fatality rate, and the serum carbohydrate antigen 125 (CA125) level, white blood cell count, neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in high MLR group all were higher those in low MLR group, and all the differences were statistically significant (P 0.05). ③The OS time of low MLR group was 87 months, which was obviously longer than that of high MLR group 38 months, and the difference was statistically significant (χ2=67.166, P<0.001). ④The multivariate Cox analysis results showed that FIGO stage Ⅲ-Ⅳ, serous ovarian cancer histopathological type, non-satisfactory ovarian cancer cytoreductive surgery, serum CA125 level≥35 U/mL, MLR≥0.26, NLR and PLR all were independent risk factors of OS time in EOC patients (HR=8.370, 95%CI: 5.094-13.753, P<0.001; HR=1.851, 95%CI: 1.171-2.924, P=0.008; HR=0.345, 95%CI: 0.234-0.507, P<0.001; HR=2.434, 95%CI: 1.538-3.851, P<0.001; HR=3.364, 95%CI: 2.145-5.276, P<0.001; HR=1.106, 95%CI: 1.020-1.199, P=0.015; HR=0.998, 95%CI: 0.996-1.000, P=0.021). Conclusions MLR is an independent prognostic factor affecting the survival of patients with EOC. Since this study is a retrospective study and the sample size is relatively small, the authenticity and accuracy of MLR predicting the prognosis of EOC patients should be confirmed by multicenter, large sample and randomized controlled studies. Key words: Epithelial ovarian cancer; Monocyte-to-lymphocyte ratio; Prognosis; Women