Lymphocyte-to-monocyte ratio combined with CA19-9 for predicting postoperative recurrence of colorectal cancer in patients with diabetes.

Abstract

ObjectiveTo investigate the significance of lymphocyte‐to‐monocyte ratio (LMR) combined with carbohydrate antigen (CA) 19‐9 for predicting postoperative recurrence of colorectal cancer (CRC) in patients with type II diabetes.MethodsWe conducted a retrospective analysis of 106 postoperative patients with stage II–III CRC and with type II diabetes. Their clinical indexes such as LMR and CA19‐9 were collected, and the patients were followed up for 5 years.ResultsThe CA19‐9 level was 119.7 U/ml at baseline in the relapsed group, while this was 24.81 U/ml in non‐relapsed group (p = 0.001). On the contrary, the LMR level was 5.10 and 2.57 for non‐relapsed and relapsed group (p < 0.001), respectively. Kaplan‐Meier survival curves stratified by CA19‐9 and LMR suggested that patients with lower CA19‐9 had higher survival probability (p < 0.001), while patients with high LMR level had higher survival probability (p < 0.001). The multivariable Cox proportional hazard regression analysis with CA19‐9 and LMR indicated that although the baseline CA19‐9 is significantly associated with increasing risk of disease recurrence, the HR (HR = 1.0, 95% CI 1.00–1.01) was small and close to 1, whereas the high baseline LMR (HR = 0.44, 95% CI 0.32–0.61) was associated with decrease in disease recurrence. Model with continuous CA19‐9 and LMR was able to better predict (AUC 73.17%) the disease recurrence.ConclusionLMR combined with CA19‐9 may become a new index for predicting postoperative recurrence of CRC in patients with diabetes.