Prognostic significance of systemic inflammation-based lymphocyte- monocyte ratio in patients with lung cancer: based on a large cohort study.

Pingping Hu,Hongchang Shen,Ping Zhang,Guanghui Wang,Jiajun Du,Qi Liu,Wafik S El-Deiry

doi:10.1371/journal.pone.0108062

Pingping Hu, Hongchang Shen + Show 5 more

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https://doi.org/10.1371/journal.pone.0108062

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Journal: PloS one	Publication Date: Oct 2, 2014
Citations: 139	License type: CC BY 4.0

Affiliation: Shandong Provincial Hospital, Shandong University

Abstract

Increasing evidence indicates cancer-related inflammatory biomarkers show great promise for predicting the outcome of cancer patients. The lymphocyte- monocyte ratio (LMR) was demonstrated to be independent prognostic factor mainly in hematologic tumor. The aim of the present study was to investigate the prognostic value of LMR in operable lung cancer. We retrospectively enrolled a large cohort of patients with primary lung cancer who underwent complete resection at our institution from 2006 to 2011. Inflammatory biomarkers including lymphocyte count and monocyte count were collected from routinely performed preoperative blood tests and the LMR was calculated. Survival analyses were calculated for overall survival (OS) and disease-free survival (DFS). A total of 1453 patients were enrolled in the study. The LMR was significantly associated with OS and DFS in multivariate analyses of the whole cohort (HR = 1.522, 95% CI: 1.275–1.816 for OS, and HR = 1.338, 95% CI: 1.152–1.556 for DFS). Univariate subgroup analyses disclosed that the prognostic value was limited to patients with non-small-cell lung cancer (NSCLC) (HR: 1.824, 95% CI: 1.520–2.190), in contrast to patients with small cell lung cancer (HR: 1.718, 95% CI: 0.946–3.122). Multivariate analyses demonstrated that LMR was still an independent prognostic factor in NSCLC. LMR can be considered as a useful independent prognostic marker in patients with NSCLC after complete resection. This will provide a reliable and convenient biomarker to stratify high risk of death in patients with operable NSCLC.

Highlights

Lung cancer remains the leading cause of cancer death worldwide [1]
Patients We conducted a retrospective study on consecutive lung cancer patients, who underwent complete resection at Shandong Provincial Hospital Affiliated to Shandong University between January 2006 and December 2011
The haematological variables including lymphocyte and monocyte count were obtained from blood tests routinely performed 1–3 days before operation, and the lymphocyte- monocyte ratio (LMR) was calculated by dividing the lymphocyte count by the monocyte count

Summary

Introduction

Despite the improvement of treatment strategy, the outcome of lung cancer is still poor. Recent findings have revealed that the outcomes of cancer patients are determined by the characteristics of tumour, and the patientrelated factors. The interactions between tumour and host response have not been fully elucidated. Of great interest is the emerging role of inflammation, one hallmark of cancer [2], which affects many aspects of malignancy. New paradigm in cancer treatment focuses on identifying prognostic indicators of malignancies which allows for the appropriate risk stratification of cancer patients and subsequent treatment allocation [3,4]. Inflammatory biomarkers reflect the response of host to malignant tumors and hold great expectations for improving predictive ability of existing prognostic factors [5]

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