Predictive values of preoperative LMR and PLR in early postoperative recurrence of patients with esophageal squamous cell carcinoma

doi:10.3760/cma.j.cn371439-20190712-00059

Abstract

Abstract:

Objective To explore the predictive values of preoperative peripheral blood lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) in early postoperative recurrence of patients with esophageal squamous cell carcinoma. Methods A total of 83 patients with esophageal squamous cell carcinoma who underwent radical surgery in the First Affiliated Hospital of Nanjing Medical University from November 2015 to December 2018 were collected. Patients were divided into recurrent group (n=41) and control group (n=42) according to the recurrence within 1 year. The levels of LMR and PLR before operation were detected by automatic blood analyzer, and the differences of LMR and PLR between the two groups were compared. The values of LMR, PLR and the combination of LMR and PLR in predicting early postoperative recurrence of esophageal squamous cell carcinoma were analyzed by receiver operating characteristic (ROC) curve. Results Compared with the control group, the recurrence group had smaller LMR (3.91±1.73 vs. 5.08±2.15; t=2.710, P=0.008), larger PLR (142.81±67.80 vs. 114.03±42.47; t=2.324, P=0.023), larger tumor diameter [(4.28±1.61) cm vs.(3.19±1.30) cm; t=3.420, P=0.001], deeper infiltration (Z=2.633, P=0.008) and later clinical stage (Z=2.616, P=0.009), with statistically significant differences. The sensitivity and specificity of LMR in predicting recurrence of esophageal cancer after surgery were 69.0% and 58.5% respectively, with the area under the curve of 0.666 (95%CI: 0.551-0.782, P=0.009) and a critical value of 4.12. The sensitivity and specificity of PLR in predicting recurrence of esophageal cancer after surgery were 51.2% and 78.6% respectively, with the area under the curve of 0.642 (95%CI: 0.522-0.761, P=0.026) and a critical value of 130.85. The sensitivity and specificity of LMR combined with PLR were 68.3% and 61.9% respectively, and area under the curve of ROC was 0.675 (95%CI: 0.560-0.791, P=0.006). Patients with low LMR and high PLR had higher risk of recurrence rate [81.0%(17/21)] than those with high LMR and low PLR [35.1%(13/37)], and the difference was statistically significant (P=0.001). Conclusion Preoperative LMR and PLR are effective indicators for early postoperative recurrence in patients with esophageal squamous cell carcinoma, and the combination of LMR and PLR has a higher predictive value.

Key words: Esophageal neoplasms, Lymphocytes, Monocytes, Blood patelets, Recurrence

Wang Tingting, Liu Lianke. Predictive values of preoperative LMR and PLR in early postoperative recurrence of patients with esophageal squamous cell carcinoma[J]. Journal of International Oncology, 2020, 47(8): 467-471.

Figures/Tables 3

References 16

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临床病理特征	复发组 (n=41)	对照组 (n=42)	t/χ²/Z值	P值
年龄(岁,$\bar{x}±s$)	62.0±7.2	62.8±5.9	0.560	0.577
性别[例(%)]
男	38(92.7)	35(83.3)	1.711	0.191
女	3(7.3)	7(16.7)
LMR($\bar{x}±s$)	3.91±1.73	5.08±2.15	2.710	0.008
PLR($\bar{x}±s$)	142.81±67.80	114.03±42.47	2.324	0.023
分化程度 [例(%)]
Ⅰ级	1(2.4)	2(4.8)	0.321	0.571
Ⅱ~Ⅲ级	40(97.6)	40(95.2)
肿瘤直径 (cm,$\bar{x}±s$)	4.28±1.61	3.19±1.30	3.420	0.001
浸润深度 [例(%)]
T₁	4(9.8)	11(26.2)
T₂	8(19.5)	13(30.9)	2.633	0.008
T₃	29(70.7)	18(42.9)
T₄	0(0)	0(0)
淋巴结转移 [例(%)]
有	34(82.9)	27(64.3)	3.701	0.054
无	7(17.1)	15(35.7)
临床分期 [例(%)]
Ⅰ期	0(0)	5(11.9)
Ⅱ期	10(24.3)	15(35.7)	2.616	0.009
Ⅲ期	27(65.9)	21(50.0)
ⅣA期	4(9.8)	1(2.4)
术后治疗 [例(%)]
是	40(97.6)	37(88.1)	2.772	0.096
否	1(2.4)	5(11.9)

组别	例数	复发例数	复发率 (%)
低LMR低PLR组 (LMR<4.12,PLR<130.85)	16	7	43.8
低LMR高PLR组 (LMR<4.12,PLR≥130.85)	21	17	81.0
组别	例数	复发例数	复发率 (%)
高LMR低PLR组 (LMR≥4.12,PLR<130.85)	37	13	35.1
高LMR高PLR组 (LMR≥4.12,PLR≥130.85)	9	4	44.4