An Elevated Peripheral Blood Monocyte-to-Lymphocyte Ratio Predicts Poor Prognosis in Patients with Primary Pulmonary Lymphoepithelioma-Like Carcinoma

Abstract

Primary pulmonary lymphoepithelioma-like carcinoma (LELC) is a rare type of non-small cell lung cancer. In this study, we retrospectively reviewed the data from 74 consecutive patients with pulmonary LELC and investigated the prognostic value of pretreatment monocyte-to-lymphocyte ratio (MLR). The cut-off value determined by ROC curve for MLR was 0.262. According to this cut-off value, 36 (48.6%) patients had lower MLR value (<0.262) at diagnosis. There was no significant correlation between MLR level and gender, age, smoking history, stage, and lactate dehydrogenase (LDH) level. The 2-year, 5-year, and 10-year OS rate were 86%, 72%, and 61%, respectively; the 2-year, 5-year, and 10-year PFS rate were 71%, 63%, and 49%, respectively. In univariate analysis, advanced stage, elevated LDH level, and higher MLR value (> = 0.262) were significantly associated with poor OS and PFS. In a multivariate Cox regression model that included stage, LDH and MLR level, all of these three factors were found to be independent prognostic factors for both PFS and OS. In patients who received radical surgery, MLR level remained significantly correlated with OS and PFS. In conclusion, we firstly demonstrated that pretreatment MLR can be used as a useful independent prognostic marker in patients with pulmonary LELC, and might guide us to optimize the treatment strategies. However, due to the relatively rarity of this disease and the limitation of a retrospective study, further prospective studies performed in multicenter are necessary to validate the prognostic value of MLR in pulmonary LELC.

Preoperative prognostic nutritional index is a powerful predictor of prognosis in patients with stage III ovarian cancer

“…Patients with only one of these abnormal levels were given a score of 1 12 . BMI, CAR, and LMR were categorized into two groups according to the cutoff values of ≥18.5 kg/m 2 , ≥0.5, and ≥3.82, respectively 9 , 37 , 38 .…”

Prognostic role of lymphocyte to monocyte ratio for patients with cancer: evidence from a systematic review and meta-analysis

“…In addition, Markovic et al [35] reported a non-significant result for DLBCL (HR: 0.70, 95% CI: 0.40–1.23; P = 0.212) (Figure 5A). Eighteen studies comprising 5,805 patients reported hazard ratios for PFS [15, 16, 28, 31, 36, 39, 41, 42, 46, 48, 50, 52, 54, 57–60, 62]. The effect of LMR on PFS among cancer subgroups is presented in Figure 5B.…”

Clinicopathological features and prognosis of primary pulmonary lymphoepithelioma-like carcinoma

“…LELC patients exhibited superior OS; the therapeutic outcome was also improved than the other two subtypes, and LELC was considered as an independent factor for prognosis (14). It was reported that the 2-year OS for different observations with 35, 52, and 74 LELC patients was 81%, 88%, and 86%, respectively, while the 5-year OS was 51%, 62%, and 72%, respectively (9,13,27). Moreover, the 5-year PFS and OS were 68% and 79%, respectively for the reports from Jiang et al based on 79 LELC patients (28).…”

“…Therefore, the prognosis of LELC was satisfactory. An improved OS could be found in the patients with the tumor at an early stage, without lymph node metastasis, and radical resection (13); the OS and DFS were worse for patients at the advanced stage of the tumor (27). It was reported that smoking (11) and staging of the tumor (11,28) were the two independent factors influencing OS as analyzed by COX regression; whereas, the diameter and the staging of the tumor (28) were the independent factors influencing DFS.…”