摘要
目的探讨在以FOLFIRI方案一线化疗的转移性结直肠癌患者中,化疗前外周血的淋巴细胞与单核细胞的比值（LMR）对于临床预后的预测价值。方法 2011~2014年间就诊于同济医院的125例接受FOLFIRI方案一线化疗并且有可用基线期血细胞计数资料的患者纳入研究。LMR的分界值由时间依赖的受试者工作曲线（ROC）分析确定,LMR被分为〉3.6和≤3.6两组;生存曲线由Kaplan-Meier方法决定;生物标志物的独立预测作用由基于Cox回归模型的多因素分析来决定。结果在125例患者中,LMR≤3.6的患者与LMR〉3.6的患者相比,无进展生存期（PFS）较短（7.0月vs.9.9月,P=0.002）,总生存（OS）较短（13.6月vs.22.3月,P=0.011）。在多因素Cox回归分析中,LMR≤3.6的患者与LMR〉3.6的患者相比,疾病进展风险增高（HR1.989,95%CI 1.289~3.068,P=0.002）,死亡风险增高（HR2.132,95%CI1.285~3.536,P=0.003）。结论在中国人群中,LMR是以FOLFIRI方案一线化疗的转移性结直肠癌患者的独立的预后因素,较低的LMR与较短的PFS和OS相关。
Objective To investigate the value of the circulating lymphocyte-to-monocyte ratio（LMR）prior to the commencement of chemotherapy in predicting clinical outcomes of metastatic colorectal cancer（mCRC）patients undergoing FOLFIRI first-line chemotherapy. Methods The present study was based on a prospective clinical trial in a Chinese population. Baseline complete blood cell counts were recorded. The optimal cutoff value for LMR was determined using time-dependent receiver op- erating curve（ROC）analysis, and patients were divided into two groups according to the value of LMR≤3.6 and〉 3.6. Survival was determined by the Kaplan-Meier method. Multivariate analyses based on the Cox regression model were performed to determine the independent predicting effect of the biomarker. Results Among the 125 patients,patients with LMR≤3.6 had shorter progression-free survival（PFS）（7.0 vs. 9.9 months, P = 0. 002）and overall survival （OS） （13.6 vs. 22.3 months, P = 0. 011 ） compared with those with LMR〉3.6. The multivariate Cox regression analysis showed that patients with LMR≤3.6 had an increased risk of disease progression（HR 1. 989,95 % CI 1. 289 -- 3. 068, P = 0. 002） and death （ HR 2. 132,95 % CI 1. 285 - 3. 536,P=0. 003）compared with those with LMR〉3.6. Conclusion LMR is an independent prognostic marker of mCRC patients treated with first-line FOLFIRI in the Chinese population,and lower LMR is predictive of worse PFS and OS.
出处
《华中科技大学学报（医学版）》
CAS
CSCD
北大核心
2016年第2期136-140,共5页
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
基金
国家自然科学基金资助项目(No.81001067
81372663)
湖北省自然科学基金资助项目(No.2013CFB114)
