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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和中性粒细胞之和的比值(LTMNR)对于临床预后的预测价值。方法:我们记录了化疗前的血细胞计数。LTMNR的分界值由时间依赖的受试者工作特征曲线(ROC)分析确定。生存曲线由Kaplan-Meier方法获得。指标的独立预测作用由基于Cox回归模型的多因素分析来确定。结果:在125例患者中,小于分界值的LTMNR与较短的无进展生存期(PFS)相关(12.3月vs 7.9月,P=0.003),与较短的总生存期(OS)相关(29.6月vs 18.0月,P=0.016)。在多因素分析中,LTMNR较低的患者疾病进展风险[风险比(HR)=3.025;95%置信区间(CI)=1.627-5.626;P<0.001]和死亡风险(HR=3.226;95%CI=1.511-6.891;P=0.002)均比LTMNR较高者升高。结论:LTMNR是中国人群中接受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,LTMNR较低的患者不论PFS还是OS均短于LTMNR较高的患者。
Objective: To investigate the prognostic value of the ratio of lymphocyte to monocyte and neutrophil in peripheral blood before chemotherapy in patients with metastatic colorectal cancer treated with FOLFIRI regimen. Methods: We recorded the blood count before chemotherapy. The cut-off value for LTMNR was determined by a time-dependent receiver operating characteristic (ROC) analysis. Survival curves were obtained by the Kaplan-Meier method. The independent predictive value of the indicator was determined by a multivariate analysis based on the Cox regression model. Results: LTMNR was associated with shorter progression-free survival (PFS) in 125 patients (p = 0.003 at 12.3 vs 7.9 months) and was associated with a shorter overall survival (OS) of 29.6 Month vs 18.0 months, P = 0.016). In the multivariate analysis, patients with lower LTMNR had a higher risk of developing disease (hazard ratio (HR) = 3.025; 95% confidence interval (CI) = 1.627-5.626; P <0.001] and risk of death (HR = 3.226; 95% CI = 1.511-6.891; P = 0.002) were higher than those with higher LTMNR. CONCLUSIONS: LTMNR is an independent prognostic factor in patients with metastatic colorectal cancer receiving first-line chemotherapy with FOLFIRI in the Chinese population. Patients with low LTMNR have shorter PFS or OS than patients with higher LTMNR.