Prognostic significance of preoperative lymphocyte to monocyte ratio in patients with signet ring gastric cancer.

World J Gastrointest Surg

Institute for Rational and Safe Medication Practices National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, Hunan Province, China.

Published: August 2023

AI Article Synopsis

  • The study investigates the predictive accuracy of the lymphocyte-to-monocyte ratio (LMR) for prognosis in patients with signet ring gastric cancer.
  • Analysis of data from 212 patients revealed multiple factors, including tumor invasion depth and preoperative LMR, that significantly impact patient survival.
  • Ultimately, preoperative LMR and other identified variables could serve as important prognostic indicators for managing signet ring gastric cancer.

Article Abstract

Background: The ratio of lymphocytes to monocytes (LMR) has been shown to be an effective predictor of gastric cancer prognosis. However, its predictive accuracy for signet ring gastric cancer is currently not well understood.

Aim: To evaluate the prognosis predictive accuracy of preoperative LMR in signet ring gastric cancer.

Methods: A total of 212 signet ring gastric cancer patients admitted at the Xiangya Hospital of Central South University, Department of Gastrointestinal Surgery, from January 2012 to December 2016 were enrolled in the study. The prognosis predictive accuracy of preoperative LMR was explored based on the area under the receiver operating characteristic. Factors that significantly affect the survival of patients were identified using single factor analysis, and those that were independently associated with signet ring gastric cancer were identified through multivariate analysis.

Results: The results of the single factor analysis revealed a strong correlation between the survival of signet ring gastric cancer patients and several factors, including tumor invasion ( = 49.726; < 0.001), lymph node metastasis ( = 30.269; < 0.001), pTNM stage ( = 49.322; < 0.001), surgical approach ( = 8.489; = 0.004), age ( = -2.213; < 0.028), carcinoembryonic antigen (CEA) (Z = -3.265; = 0.001), platelet-to-lymphocyte ratio (Z = -2.196; = 0.028), LMR (Z = -2.226; = 0.026), ALB ( = 3.284; = 0.001), prognostic nutritional index ( = -3.789; < 0.001) and FIB (Z = -3.065; = 0.002). Furthermore, the multivariate analysis further demonstrated that age (HR: 0.563, 95%CI: 0.363-0.873), tumor invasion depth (HR: 0.226, 95%CI: 0.098-0.520), pTNM stage (HR: 0.444, 95%CI: 0.255-0.771), preoperative CEA level (HR: 0.597, 95%CI: 0.386-8.790), and preoperative LMR level (HR: 1.776, 95%CI: 1.150-2.741) were independent factors influencing the prognosis of signet ring gastric cancer.

Conclusion: In signet ring gastric cancer patients, a low preoperative LMR level predicts poor prognosis. The death risk ratio of the low LMR group compared to the high LMR group is 1.776.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10494583PMC
http://dx.doi.org/10.4240/wjgs.v15.i8.1673DOI Listing

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