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A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma.
PLoS One 2013; 8(12):e83069Plos

Abstract

BACKGROUND

Nasopharyngeal carcinoma (NPC) is an endemic neoplasm in southern China. Although NPC sufferers are sensitive to radiotherapy, 20-30% of patients finally progress with recurrence and metastases. Elevated lymphocyte-to-monocyte ratio (LMR) has been reported to be associated with favorable prognosis in some hematology malignancies, but has not been studied in NPC. The aim of this study was to evaluate whether LMR could predict the prognosis of NPC patients.

METHODS

A retrospective cohort of 1,547 non-metastatic NPC patients was recruited between January 2005 and June 2008. The counts for peripheral lymphocyte and monocyte were retrieved, and the LMR was calculated. Receiver operating characteristic curve analysis, univariate and multivariate COX proportional hazards analyses were applied to evaluate the associations of LMR with overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and loco-regional recurrence-free survival (LRRFS), respectively.

RESULTS

Univariate analysis revealed that higher LMR level (≥ 5.220) was significantly associated with superior OS, DFS and DMFS (P values <0.001). The higher lymphocyte count (≥ 2.145 × 10(9)/L) was significantly associated with better OS (P = 0.002) and DMFS (P = 0.031), respectively, while the lower monocyte count (<0.475 × 10(9)/L) was associated with better OS (P = 0.012), DFS (P = 0.011) and DMFS (P = 0.003), respectively. Multivariate Cox proportional hazard analysis showed that higher LMR level was a significantly independent predictor for superior OS (hazard ratio or HR = 0.558, 95% confidence interval or 95% CI = 0.417-0.748; P<0.001), DFS (HR = 0.669, 95% CI = 0.535-0.838; P<0.001) and DMFS (HR = 0.543, 95% CI = 0.403-0.732; P<0.001), respectively. The advanced T and N stages were also independent indicators for worse OS, DFS, and DMFS, except that T stage showed borderline statistical significance for DFS (P = 0.053) and DMFS (P = 0.080).

CONCLUSIONS

The elevated pretreatment peripheral LMR level was a significant favorable factor for NPC prognosis and this easily accessed variable may serve as a potent marker to predict the outcomes of NPC patients.

Authors+Show Affiliations

Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Epidemiology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Nasopharyngeal Carcinoma, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.Collaborative Innovation Center for Cancer Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China ; Department of Experimental Research, Sun Yat-sen University Cancer Center, Guangzhou, People's Republic of China.

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24386144

Citation

Li, Jing, et al. "A Large Cohort Study Reveals the Association of Elevated Peripheral Blood Lymphocyte-to-monocyte Ratio With Favorable Prognosis in Nasopharyngeal Carcinoma." PloS One, vol. 8, no. 12, 2013, pp. e83069.
Li J, Jiang R, Liu WS, et al. A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma. PLoS ONE. 2013;8(12):e83069.
Li, J., Jiang, R., Liu, W. S., Liu, Q., Xu, M., Feng, Q. S., ... Zeng, Y. X. (2013). A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma. PloS One, 8(12), pp. e83069. doi:10.1371/journal.pone.0083069.
Li J, et al. A Large Cohort Study Reveals the Association of Elevated Peripheral Blood Lymphocyte-to-monocyte Ratio With Favorable Prognosis in Nasopharyngeal Carcinoma. PLoS ONE. 2013;8(12):e83069. PubMed PMID: 24386144.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A large cohort study reveals the association of elevated peripheral blood lymphocyte-to-monocyte ratio with favorable prognosis in nasopharyngeal carcinoma. AU - Li,Jing, AU - Jiang,Rou, AU - Liu,Wen-Sheng, AU - Liu,Qing, AU - Xu,Miao, AU - Feng,Qi-Sheng, AU - Chen,Li-Zhen, AU - Bei,Jin-Xin, AU - Chen,Ming-Yuan, AU - Zeng,Yi-Xin, Y1 - 2013/12/27/ PY - 2013/08/26/received PY - 2013/11/08/accepted PY - 2014/1/4/entrez PY - 2014/1/5/pubmed PY - 2014/10/1/medline SP - e83069 EP - e83069 JF - PloS one JO - PLoS ONE VL - 8 IS - 12 N2 - BACKGROUND: Nasopharyngeal carcinoma (NPC) is an endemic neoplasm in southern China. Although NPC sufferers are sensitive to radiotherapy, 20-30% of patients finally progress with recurrence and metastases. Elevated lymphocyte-to-monocyte ratio (LMR) has been reported to be associated with favorable prognosis in some hematology malignancies, but has not been studied in NPC. The aim of this study was to evaluate whether LMR could predict the prognosis of NPC patients. METHODS: A retrospective cohort of 1,547 non-metastatic NPC patients was recruited between January 2005 and June 2008. The counts for peripheral lymphocyte and monocyte were retrieved, and the LMR was calculated. Receiver operating characteristic curve analysis, univariate and multivariate COX proportional hazards analyses were applied to evaluate the associations of LMR with overall survival (OS), disease-free survival (DFS), distant metastasis-free survival (DMFS) and loco-regional recurrence-free survival (LRRFS), respectively. RESULTS: Univariate analysis revealed that higher LMR level (≥ 5.220) was significantly associated with superior OS, DFS and DMFS (P values <0.001). The higher lymphocyte count (≥ 2.145 × 10(9)/L) was significantly associated with better OS (P = 0.002) and DMFS (P = 0.031), respectively, while the lower monocyte count (<0.475 × 10(9)/L) was associated with better OS (P = 0.012), DFS (P = 0.011) and DMFS (P = 0.003), respectively. Multivariate Cox proportional hazard analysis showed that higher LMR level was a significantly independent predictor for superior OS (hazard ratio or HR = 0.558, 95% confidence interval or 95% CI = 0.417-0.748; P<0.001), DFS (HR = 0.669, 95% CI = 0.535-0.838; P<0.001) and DMFS (HR = 0.543, 95% CI = 0.403-0.732; P<0.001), respectively. The advanced T and N stages were also independent indicators for worse OS, DFS, and DMFS, except that T stage showed borderline statistical significance for DFS (P = 0.053) and DMFS (P = 0.080). CONCLUSIONS: The elevated pretreatment peripheral LMR level was a significant favorable factor for NPC prognosis and this easily accessed variable may serve as a potent marker to predict the outcomes of NPC patients. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/24386144/A_large_cohort_study_reveals_the_association_of_elevated_peripheral_blood_lymphocyte_to_monocyte_ratio_with_favorable_prognosis_in_nasopharyngeal_carcinoma_ L2 - http://dx.plos.org/10.1371/journal.pone.0083069 DB - PRIME DP - Unbound Medicine ER -