The prognostic value of the lymphocyte-to-monocyte ratio for high-risk papillary thyroid carcinoma
Authors Song L, Zhu J, Li Z, Wei T, Gong R, Lei J
Received 12 June 2019
Accepted for publication 22 August 2019
Published 17 September 2019 Volume 2019:11 Pages 8451—8462
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Yong Teng
Linlin Song,1,2 Jingqiang Zhu,1 Zhihui Li,1,3 Tao Wei,1,3 Rixiang Gong,1,3 Jianyong Lei1
1Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China; 2West China School of Medicine, Sichuan University, Chengdu 610065, People’s Republic of China; 3Thyroid and Breast Surgery Center, Chengdu Shang Jin Nan Fu Hospital, Chengdu 611700, People’s Republic of China
Correspondence: Jianyong Lei
Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu 610041, People’s Republic of China
Tel +86 288 542 3822
Fax +86 288 542 3822
Background and Aims: The prognosis of papillary thyroid carcinoma (PTC) is highly variable, even for high-risk cases. The predictive and prognostic role of the lymphocyte-to-monocyte ratio (LMR) has been reported in other cancers. The aim of our present study was to explore the value of LMR prognostic prediction in high-risk PTC patients.
Patients and Methods: Two hundred and twenty-four PTC high-risk cases at West China Hospital were randomized into a training set (112 cases) and testing set (112 cases), while 48 cases in Shang Jin Nan Fu Hospital were included as the external validation set.
Results: A lower preoperative LMR correlated with larger tumor size, advanced N and M stages, and an increased number of multiple PTC cases in the training, testing, and validation sets (all P<0.05 in the three sets). Patients with a high LMR exhibited significantly improved overall and PTC-free survival compared with those of patients with a low LMR in the training, testing, validation, and combined sets (all P<0.05 in the individual and combined sets). Moreover, multivariate analyses identified the LMR as an independent prognostic factor for overall and PTC-free survival. The nomograms for predicting the 5-year mortality and PTC recurrence were developed based on the risk factors in the training set and validated in the independent testing and validation sets.
Conclusion: The preoperative LMR was identified as an independent prognostic factor that could be incorporated into the two nomograms with other risk factors to predict overall survival and PTC-free survival for individual patients.
Keywords: lymphocyte-to-monocyte ratio, papillary thyroid carcinoma, lymph node metastasis, recurrence
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