Preoperative lymphocyte-to-monocyte ratio predicts survival in primary hepatitis B-virus positive hepatocellular carcinoma after curative resection
Authors Li G, Ji J, Yang F, Xu H, Bai Y
Received 12 April 2016
Accepted for publication 23 August 2016
Published 23 February 2017 Volume 2017:10 Pages 1181—1189
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Manfred Beleut
Peer reviewer comments 5
Editor who approved publication: Professor Min Li
Guang-Jun Li,1 Juan-Juan Ji,2 Fang Yang,2 Hong-Wei Xu,1 Yu Bai3
1First Department of General Surgery, 2Department of Gastroenterology, 3Department of Pathology, The First Affiliated Hospital of Xin-Xiang Medical University, Henan, People’s Republic of China
Background: Both inflammation and immunity are associated with the development of malignancy. The lymphocyte-to-monocyte ratio (LMR) has been confirmed as a prognostic factor for several malignant diseases. The purpose of our study was to analyze prognostic significance of preoperative LMR in hepatitis B virus (HBV)-related hepatocellular carcinoma after curative resection.
Patients and methods: A total of 253 patients with primary HBV-positive hepatocellular carcinoma who underwent a curative operation were enrolled in this retrospective study. The relationship between preoperative LMR and survival outcomes was analyzed through Kaplan–Meier curves and multivariate Cox regression analyses.
Results: Patients with a high LMR had a significantly higher mean overall survival than those with a low LMR (67 months vs 55 months, P=0.023), and high LMR remained significant for longer survival in the multivariate analysis (hazard ratio, 0.147; 95% confidence interval [CI]: 0.085–0.253; P=0.021). Furthermore, patients with a high LMR also had a higher median recurrence-free survival than those with a low LMR in univariate analyses (60 months vs 48 months, P=0.026) and multivariate analyses (hazard ratio, 0.317; 95% CI: 0.042–1.023; P=0.032). However, the survival benefit was limited to patients with advanced cancer.
Conclusion: LMR was confirmed as an independent prognostic biomarker for primary HBV-positive hepatocellular carcinoma after curative resection.
Keywords: lymphocyte-to-monocyte ratio, survival, HBV, hepatocellular carcinoma