Low Lymphocyte-to-Monocyte Ratios Are Associated with Poor Overall Survival in Anaplastic Thyroid Carcinoma Patients

Abstract

Background: The lymphocyte-to-monocyte ratio (LMR), which reflects the tumor-infiltrating immune cell status and host immunity, has been reported as a prognostic marker in various cancers. The aim of the present study was to evaluate the role of the LMR as a prognostic marker in predicting the survival of patients with anaplastic thyroid carcinoma (ATC). Methods: This study retrospectively included 35 ATC patients with available complete blood cell count data. The primary outcome was the overall survival (OS) of patients with ATC. Results: There were no significant differences between the LMR of the baseline and that of the follow-up complete blood cell count data (p = 0.53). The patients were divided into two groups based on their baseline LMR: a low LMR group (<4; n = 23, 66%) and a high LMR group (‡4; n = 12, 34%). The proportion of cervical lymph node metastasis in the low LMR group was significantly higher than that in the high LMR group (p = 0.021). The OS curves were significantly different based on the LMR values, and the median OS of the low and high LMR groups were 3.0 and 9.5 months, respectively (p = 0.004). In multivariate analysis, a low LMR was also an independent risk factor for all-cause mortality in patients with ATC (hazard ratio = 2.55 [confidence interval 1.08-6.00], p = 0.032) after adjusting for sex, tumor size, and distant metastasis. Conclusions: A low LMR is associated with poor survival in patients with ATC. The LMR could be a simple and stable prognostic biomarker reflecting host immunity in patients with ATC. Further studies are needed to confirm the prognostic role of the LMR in ATC.

Prognostic role of the lymphocyte‐to‐monocyte ratio for clinical outcomes of patients with progressive radioiodine‐refractory differentiated thyroid carcinoma treated by sorafenib

“…Thus, the LMR from the peripheral blood represents tumour immunity and pro‐tumorigenic environments show a low LMR, while antitumorigenic environments tend to have high LMR . In thyroid cancer, we previously showed an association between the LMR and the prognosis of patients with ATC . The present study used LMR cut‐off values from the previous ATC study and found that a value of 4 to be an appropriate cut‐off value of LMR in thyroid cancer.…”

“…13 In thyroid cancer, we previously showed an association between the LMR and the prognosis of patients with ATC. 11 The present study used LMR cut-off values from the previous ATC study and found that a value of 4 to be an appropriate cut-off value of LMR in thyroid cancer. Then, the LMR had significant meaning as a prognostic factor in patients with progressive RAIR DTC.…”

“…It was also similar to that from the previous study. 11 The patients were divided into low (<4) and high LMR (≥4) groups.…”

“…The lymphocyte-to-monocyte ratio (LMR) has been reported to reflect host immunity in various malignancies. [11][12][13][14] Peripheral lymphocytes represent tumour-related lymphocytes, while peripheral monocytes represent TAMs. Therefore, low and high LMRs indicate weak and strong immune responses against tumours, respectively.…”

“…13 In a previous study, a low LMR was related to poor prognosis in patients with anaplastic thyroid carcinoma (ATC). 11 However, to our knowledge, no clinical studies have assessed the association between the LMR and DTC. The present analysis included patients with progressive RAIR DTC treated with sorafenib who were candidates for immune-based therapies.…”