Prognostic Significance of Preoperative Lymphocyte-Monocyte Ratio in Patients with Resectable Esophageal Squamous Cell Carcinoma

Abstract

Background: The interaction between tumor cells and inflammatory cells has not been systematically investigated in esophageal squamous cell carcinoma (ESCC). The aim of the present study was to evaluate whether preoperative the lymphocyte-monocyte ratio (LMR), the neutrophil-lymphocyte ratio (NLR), and the platelet-lymphocyte ratio (PLR) could predict the prognosis of ESCC patients undergoing esophagectomy. Materials and Methods: Records from 218 patients with histologically diagnosed ESCC who underwent attempted curative surgery from January 2007 to December 2008 were retrospectively reviewed. Besides clinicopathological prognostic factors, we evaluated the prognostic value of the LMR, the NLR, and the PLR using Kaplan-Meier curves and Cox regression models. Results: The median follow-up was 38.6 months (range 3-71 months). The cutoff values of 2.57 for the LMR, 2.60 for the NLR and 244 for the PLR were chosen as optimal to discriminate between survival and death by applying receiver operating curve (ROC) analysis. Kaplan-Meier survival analysis of patients with low preoperative LMR demonstrated a significant worse prognosis for DFS (p=0.004) and OS (p=0.002) than those with high preoperative LMR. The high NLR cohort had lower DFS (p=0.004) and OS (p=0.011). Marginally reduced DFS (p=0.068) and lower OS (p=0.039) were found in the high PLR cohort. On multivariate analysis, only preoperative LMR was an independent prognostic factor for both DFS (p=0.009, HR=1.639, 95% CI 1.129-2.381) and OS (p=0.004, HR=1.759, 95% CI 1.201-2.576) in ESCC patients. Conclusions: Preoperative LMR better predicts cancer survival compared with the cellular components of systemic inflammation in patients with ESCC undergoing esophagectomy.

The clinical significance of systemic inflammation score in esophageal squamous cell carcinoma

“…They also found that LMR was associated with tumor progression and could be considered as an independent predictive marker of prognosis in ESCC [31]. Our previous study also revealed that LMR could better predict cancer survival compared with NLR and PLR in ESCC [14]. In the present study, we found that the serum albumin decreased in parallel with the advancement of T stage.…”

“…Previous studies also pointed out that preoperative LMR might better predict cancer survival compared with other inflammatory marks [12,13]. Our previous study also found that LMR was a better prognostic factor compared with NLR and PLR in ESCC patients undergoing esophagectomy [14]. Thus, systemic inflammation score (SIS), a novel prognostic score consisted of serum albumin and LMR, may be a better predictive factor for postoperative clinical outcome in malignancies.…”

Association of lymphocyte-to-monocyte ratio with the no-reflow phenomenon in patients who underwent a primary percutaneous coronary intervention for ST-elevation myocardial infarction

“…Recently, studies have shown that it is an indicator of systemic inflammatory response and it has been shown to present a potential prognostic factor in various types of malignancies [18][19][20]. In addition, it has been shown that a decreased LMR is associated significantly with a high risk for critical limb ischemia and other vascular endpoints in peripheral arterial occlusive disease patients [27].…”

“…The lymphocyte-to-monocyte ratio (LMR) is another inflammatory marker [18]. Recently, studies have shown that LMR is associated with prognosis in various cancers [18][19][20]. However, to the best of our knowledge, the clinical availability of LMR in cardiovascular diseases has not been known.…”

Upregulated miR-193a-3p as an oncogene in esophageal squamous cell carcinoma regulating cellular proliferation, migration and apoptosis

“…ESCC is also the major histological type in Chinese populations, resulting in 150,000 mortalities annually (3). Despite the availability of multiple treatments for ESCC, surgical resection remains the primary choice for non-metastatic cases (4). However, even upon curative surgery, the 5-year survival rate for ESCC patients is only 26.2-49.4%, due to local or distant recurrences (5).…”