Lymphocyte-White Cell Ratio Is a Novel Marker of Morbidity Following Colorectal Cancer Surgery

Ang, Jia Jun; Chia, D.; Chan, Dedrick Kok Hong

doi:10.1016/j.jss.2020.11.027

Cited by 5 publications

(3 citation statements)

References 33 publications

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“…The lymphocyte percentage (LWR) was an effective prognostic tool for patients with colorectal cancer [ 4 ]. Lactate dehydrogenase/lymphocyte (LDH/lymphocyte) is associated with mortality in COVID-19 patients [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis

Chen

Liu

Qiao

et al. 2022

BioMed Research International

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Background. Infective endocarditis (IE) has a high rate of mortality and the prognosis of IE was poor. The purpose of this investigation was to explore the value of lactate dehydrogenase (LDH)/lymphocyte and compare it with LDH/lymphocyte percentage (L-LWR) in predicting the in-hospital mortality in IE patients. Methods. The investigation cohort contained 147 IE patients between January 2017 and December 2019. We retrospectively went over the medical records and selected admission indexes. Results. Compared with IE patients with adverse events, significantly higher levels of LDH/lymphocyte and significantly lower levels of L-LWR were discovered in IE patients without adverse events. After adjustments, L-LWR (odds ratio (OR): 4.558, 95% confidence interval (CI) 1.362-15.256, P = 0.014 ) still maintained its significant independence. In addition, L-LWR had the highest area under curve (AUC) (0.780, 0.704-0.844, P < 0.001 ) with good sensitivity (81.89%) and specificity (65.00%) when 34 was selected as the best cutoff value. Conclusions. L-LWR is a reliable, low-priced, easily applicable, and independent prognostic parameter for in-hospital death with good performance in patients with IE.

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Section: Introductionmentioning

confidence: 99%

Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis

Chen

Liu

Qiao

et al. 2022

BioMed Research International

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“…Wang et al 11 con rmed that a low LWR contributed to a worse OS for patients with non-small cell lung cancer. Ang et al 30 even suggested that LWR could predict postoperative morbidity for patients with colorectal cancer following surgery.…”

Section: Discussionmentioning

confidence: 99%

Preoperative lymphocyte to white blood cell ratio predicts the survival of patients with hepatocellular carcinoma after liver resection: A multicenter study

Qin

Zhou

et al. 2022

Preprint

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Background Lymphocytes play a key anticancer role. However, there is little information concerning the prognostic utility of the lymphocyte to white blood cell ratio (LWR) for patients with hepatocellular carcinoma (HCC) after liver resection. Methods The data of patients with HCC who underwent liver resection at 5 centers were retrospectively reviewed. X-Tile software was used to determine the optimal cutoff values of the inflammation-based models. Univariate and multivariate analyses were used to identify the independent risk factors for both recurrence-free survival (RFS) and overall survival (OS). Multivariate Cox proportional hazard models were used to assess the independent risk factors for RFS and OS. Results A total of 1591 patients were included in this study. The multivariate analyses revealed that LWR was an independent risk factor for both RFS (HR = 1.190, 95% CI = 1.037–1.365, P = 0.013) and OS (HR = 1.300, 95% CI = 1.098–1.539, P = 0.002) for HCC patients after liver resection. LWR showed a higher predictive capacity for both RFS and OS than other inflammation-based models for patients with HCC after tumor resection. The 5-year RFS and OS were 42.9% and 60.8%, respectively, for HCC patients with a high LWR, which were significantly higher than those with a low LWR (36.9% for RFS and 49.0% for OS, both P < 0.001). Conclusions Preoperative LWR may serve as a novel marker to predict the survival of HCC patients after liver resection. Low LWR was associated with a high incidence of postoperative recurrence and mortality.

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“…要原因 (2) 。2006年进行的一项全国乙型病毒性肝炎调查显示，我国1-59岁人群乙肝表面抗原阳性率高达7.18% (3) 。由于乙肝病毒(hepatitis B virus, HBV)的高感染率，最近的一项研究表明，中国每年有40多万例新发的HCC病例，占世界新发HCC患者的一半以上 (4) 。手术切除被公认为是HCC的根治性治疗方法之一。然而，由于HCC切除术后复发率高，长期预后仍不理想 (5,6) 。许多因素可导致HCC患者术后复发。近年来，许多研究证实，全身炎症和免疫微环境在HCC的癌变、生长和转移中起着至关重要的作用 (7,8) 。淋巴细胞是抗肿瘤免疫防御的重要效应细胞。一些涉及淋巴细胞的全身性炎症模型已被提出，并用于预测HCC的预后，如中性粒细胞与淋巴细胞比率(neutrophil to lymphocyte ratio, NLR) 和血小板与淋巴细胞比率(platelet to lymphocyte ratio, PLR)等 (7) 。但是，以往的研究很少关注淋巴细胞在白细胞中的比例对HCC患者预后的影响。既往针对其他肿瘤，如鼻咽癌、结直肠癌和肺癌，的研究表明，低淋巴细胞与白细胞的比率(lymphocyte to white blood cell ratio, LWR)与不良预后有关 (9)(10)(11) 。在我们之前的研究中，我们也证实术前低LWR (<30%)是肝移植术后HCC患者复发率的独立危险因素之一 (12) (12) 。NLR定义为中性粒细胞计数除以淋巴细胞计数 (7) 。PLR定义为血小板计数除以淋巴细胞计数 (7) 。大范围肝切除术被定义为切除三个或更多肝段 (13) 。全身炎症免疫指数(systemic immune-inflammation index, SII)的定义为血小板×中性粒细胞/淋巴细胞计数。白蛋白-胆红素(albumin-bilirubin，ABLI)分级计算公式如下：ALBI = (log10 胆红素(μmol/L) × 0.66)+(白蛋白(g/L)× -0.085) (14) 。根据计算值，ALBI分为3个等级:1级(小于-2.60)， 2级(介于-2.60和-1.39之间)和3级(大于-1.39) (14) 。肿瘤负荷评分(tumor burden score, TBS)的计算公式为 (15) (16)(17)(18)(19) 。目前，既往的研究已经提出了许多模型来反映患者的全身炎症和免疫微环境。在这些模型中，许多都包含淋巴细胞，如NLR、PLR、SII等 (20) (20) 。以往的研究表明，术前ALC可以预测一些癌症的预后，如肝癌、乳腺癌和食管癌 (21)(22)(23) 。然而，在目前的研究中，我们发现低 LWR，而不是低ALC，是HCC患者肿瘤切除术后的独立预测指标。白细胞包括淋巴细胞、中性粒细胞、单核细胞等。如果患者的白细胞中淋巴细胞的比例较高，则其单核细胞和中性粒细胞的比例相对较低。在这种情况下，患者的NLR或LMR相对较好，这反映了患者拥有一个相对较好的免疫微环境。然而，如果患者ALC相对较高，那么他们的LWR并不一定较高。ALC高的患者也可能有高的中性粒细胞或单核细胞计数。这种情况下，患者的NLR或LMR可能并不理想。因此，我们认为LWR可能比ALC更能反映患者全身炎症和免疫微环境的状态。既往的一些研究也证实，LWR低与其他类型癌症患者的不良预后有关。例如，Ding等人认为LWR低与口腔鳞状细胞癌患者的转移和生存率低有关 (24) 。Wang等人证实，LWR低的非小细胞肺癌患者，OS亦较差 (9) 。Ang等人甚至认为LWR可以预测结直肠癌术后患者的术后并发症发病率 (25) 。在目前的研究中，TBS也被发现是术后复发和死亡的独立危险因素。在许多研究中，研究者通过将肿瘤直径和数量二分类的方式来预测HCC的预后。然而，一些研究人员认为，肿瘤直径和数量的二分类将限制其的预测能力 (15) 。与此前的研究不同的是，TBS是一个连续变量。许多研究均证实，TBS能更好的预测HCC患者的预后。一些研究甚至表明，TBS结合其他一些指标，如AFP和 ALBI，能更好的预测HCC患者的长期生存 …”

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The New Perspectives Journal of Medicine

2024

N Perspect J Med

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Lymphocytes play a key anticancer role. However, there is little information concerning the prognostic utility of the lymphocyte-to-white-blood-cell ratio (LWR) for patients with hepatocellular carcinoma (HCC) after liver resection. Data on patients with HCC who underwent liver resection at 5 centers were retrospectively reviewed. The software X-Tile was used to determine the optimal cutoff values for models of inflammation. Univariate and multivariate analyses were used to identify the independent risk factors for both recurrence-free survival (RFS) and overall survival (OS). Multivariate Cox proportional hazard models were used to assess the independent risk factors for RFS and OS. Subjects were a total of 1,591 patients. Multivariate analyses revealed that the LWR was an independent risk factor for both RFS (HR=1.190, 95% CI=1.037-1.365, P=0.013) and OS (HR=1.300, 95% CI=1.098-1.539, P=0.002) for patients with HCC after liver resection. The LWR displayed a greater ability to predict both RFS and OS in patients with HCC after tumor resection than other models of inflammation. The 5-year RFS and OS were 42.9% and 60.8%, respectively, for patients with HCC and a high LWR, and those rates were significantly higher than rates in patients with a low LWR (RFS of 36.9% and OS of 49.0%, P<0.001 for both). In conclusion, preoperative LWR may serve as a novel marker to predict the survival of patients with HCC after liver resection. A low LWR was associated with a high incidence of postoperative recurrence and mortality.

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Lymphocyte-White Cell Ratio Is a Novel Marker of Morbidity Following Colorectal Cancer Surgery

Cited by 5 publications

References 33 publications

Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis

Prognostic Value of a Novel Parameter in Patients with Infective Endocarditis

Preoperative lymphocyte to white blood cell ratio predicts the survival of patients with hepatocellular carcinoma after liver resection: A multicenter study

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