Pre-Operative Assesment of Lymphocyte Monocyte Ratio in Ovarian Neoplasms
Keywords:
Lymphocyte monocyte ratio, Neutrophil lymphocyte ratio, Ovarian neoplasm
Abstract
Background: Inflammation has been shown to have a prognostic role in a variety of cancers. The objective of this study was to evaluate lymphocyte monocyte ratio and neutrophil lymphocyte ratio in both benign and malignant ovarian neoplasms. Materials and methods: A total of 77 cases of ovarian neoplasms fitting our inclusion criteria were retrospectively reviewed. Clinicopathological data of the patients were analysed. The absolute blood counts of neutrophils, lymphocytes and monocytes, were collected and used to calculate the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte to monocyte ratio (LMR). The optimal cut-off value of the LMR was determined by using receiver operating characteristic curve analysis and Youden’s index. Results: Analysis revealed that benign ovarian neoplasms were statistically associated with a higher LMR when compared to malignant ovarian neoplasms (p = 0.023). A receiver operating characteristic curve analysis was performed and the area under the curve was 0.659. The optimum cut-off for LMR, calculated using Youden’s index, was determined to be 6.25, which has a relatively high sensitivity of 87.5% but a less than desirable specificity of 44.4%. No significant statistical association was found between LMR and NLR with the other clinicopathological variables. Conclusion: Our study indicates that lymphocyte monocyte ratio may serve as an important biomarker in the differentiation of benign and malignant ovarian neoplasms. However, further studies are warranted to confirm this conclusion.References
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2. Xiang J, Zhou L, Li X et al. Preoperative Monocyte-to-Lymphocyte Ratio in Peripheral Blood Predicts Stages, Metastasis, and Histological Grades in Patients with Ovarian Cancer. Translational Oncology.2016;10:33–9.
3. Zhang Y, Wang L, Liu Y et al. Preoperative neutrophil-lymphocyte ratio before platelet-lymphocyte ratio predicts clinical outcome in patients with cervical cancer treated with initial radical surgery. Int J Gynecol Cancer. 2014;24:1319–25
4. Hermanns T, Bhindi B, Wei Y et al. Pre-treatment neutrophil-to-lymphocyte ratio as predictor of adverse outcomes in patients undergoing radical cystectomy for urothelial carcinoma of the bladder. Br J Cancer. 2014;111:444–51.
5. Watanabe H, EnojiM , Imai T. Gastric carcinoma with lymphoid stroma- Its Morphologic Characteristics and Prognostic Correlations. J of Cancer .1976; 38: 232-43.
6. Yao W, He J, Yang Y et al. The Prognostic Value of Tumor infiltrating Lymphocytes in Hepatocellular Carcinoma: a Systematic Review and Metaanalysis. Scientific reports. 2017;7: 7525
7. Eo WK, Kwon S, Koh SB et al. The lymphocyte-monocyte ratio predicts patient survival and aggressiveness of endometrial cancer. J Cancer. 2016;7:538–45.
8. Qi X, Li J, Deng H et al. Neutrophil-to-lymphocyte ratio for the prognostic assessment of hepatocellular carcinoma: A systematic review and meta-analysis of observational studies.Oncotarget.2016;7: 45283-301
9. Jiang R, Cai X, Yang Z et al. Elevated peripheral blood lymphocyte to monocyte ratio predicts a favourable prognosis in the patients with metastatic nasopharyngeal carcinoma. Chinese Journal of Cancer. 2015;34:23
10. Chen L, Zhang F, Sheng XG, Zhang SQ. Decreased pretreatment lymphocyte/monocyte ratio is associated with poor prognosis in stage Ib1-IIa cervical cancer patients who undergo radical surgery. Onco Targets Ther. 2015;8:1355–62
11. Sato E, Olson SH, Ahn J et al. Intraepithelial CD8+ tumor-infiltrating lymphocytes and a high CD8C/regulatory T cell ratio are associated with favorable prognosis in ovarian cancer. Proc Natl Acad Sci U S A. 2005;102:18538-43
12. R.Y Huang, Ariel Francois A, McGray AJ ,Miliotto A, Odunsi K. Compensatory upregulation of PD-1, LAG-3, and CTLA-4 limits the efficacy of single-agent checkpoint blockade in metastatic ovarian cancer. J of Oncoimmunology. 2017;6: 1-13
13. Ni XJ, Zhang XL, Ou-Yang QW et al. An elevated peripheral blood lymphocyte-to-monocyte ratio predicts favourable response and prognosis in locally advanced breast cancer following neoadjuvant chemotherapy.2014;9:e111886
14. Yang L, Zhang Y. Tumor-associated macrophages: from basic research to clinical application. Journal of Hematology & Oncology.2017;10:1-12.
15. Stotz M, Pichler M, Absenger G et al . The preoperative lymphocyte to monocyte ratio predicts clinical outcome in patients with stage III colon cancer. Br J Cancer. 2014;110:435–40.
Published
2018-05-22
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