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Title: [Influence of Peripheral Blood Lymphocyte/Monocyte ratio (LMR) and Its Ratio to Lactate Dehydrogenase on Prognosis of Patients with Diffuse Large B-Cell Lymphoma].
Author: Yang D, Su LP.
Journal: Zhongguo Shi Yan Xue Ye Xue Za Zhi; 2020 Oct; 28(5):1563-1569. PubMed ID: 33067955.
Abstract:
OBJECTIVE: To explore the influence of lymphocyte / monocyte ratio (LMR), LMR/lactate dehydrogenase (LDH) ratio on the prognosis of patients with diffuse large B-cell lymphoma. METHODS: Clinical data of 107 newly diagnosed patients with DLBCL, including age, sex, stage, B symptoms, IPI score, ECOG score, absolute lymphocyte count, absolute value of monocytes, the ratio of lymphocyte to monocyte(LMR), LDH, LMR/LDH, and SUVmax detected by FDG-PET/CT were analyzed. The best cut-off points of LMR and LMR/LDH were determined by receiver operating characteristics (ROC) curve; the chi-square test was used to analyze the correlation of clinical factors with LMR and LMR/LDH; Spearman correlation analysis was used to determine the correlation between serum LDH level and SUVmax; the Kaplan-Meier protocol was used to compare the overall survival (OS) rate and progression-free survival (PFS) rate between LMR and LMR/LDH groups; the Cox proportional risk model was used to carry out the multivariate analysis of prognostic factors. RESULTS: The optimal limit value for LMR and LMR/LDH (%) determined by ROC curve was 2.535 （P＜0.05） and 0.35% （P＜0.01） respectively. Patients with an LMR<2.535 had a higher incidence of advanced Ann Arbor stage, B symptoms, higher IPI score, higher ECOG score, and elevated LDH level, while patients with LMR/LDH 0.35% had the same trend as patients with LMR <2.535. A significant positive correlation between serum LDH and SUVmax was observed by Spearman correlation analysis (P<0.001). K-M survival analysis showed that the PFS rate and OS rate in high LMR group were significantly better than that in the low LMR group (P<0.05). K-M analysis showed that the PFS rate and OS rate in high LMR/LDH group were statistical significantly better than that in low LMR/LDH group (P<0.05). Multivariate COX analysis showed that the predictive value in LMR/LDH was much better than single LMR, which may be an independent prognostic factor for patients with DLBCL. CONCLUSION: At the initial diagnosis, high LMR/LDH suggests that DLBCL patient is a better prognosis. 题目: 外周血淋巴细胞/单核细胞比值（LMR）及其与乳酸脱氢酶比值对弥漫大B细胞淋巴瘤患者预后的影响. 目的: 探讨淋巴细胞与单核细胞比值（LMR）、LMR与乳酸脱氢酶（LDH）的比值对弥漫大B细胞淋巴瘤（DLBCL）患者预后的影响. 方法: 回顾性分析107例初诊DLBCL患者的临床资料，包括年龄、性别、分期、B症状、IPI评分、ECOG评分、淋巴细胞绝对值、单核细胞绝对值、LMR、LDH、LMR/LDH、PET-CT检查的SUVmax。ROC曲线确定LMR和LMR/LDH的界限值；应用卡方检验分析LMR、LMR/LDH与DLBCL临床各因素的相关性；Spearman相关分析确定血清LDH水平与PET-CT检查的SUVmax的相关性；采用Kaplan-Meier方案比较不同分组的LMR和LMR/LDH患者的总生存率（OS）和无进展生存率（PFS）；用Cox比例风险模型进行影响预后因素的多变量分析. 结果: 通过ROC曲线确定LMR、LMR/LDH（%）的最佳界限值，分别为2.535（P<0.05）、0.35%（P<0.01）。LMR＜2.535更倾向于发生在临床分期较晚、有B症状、IPI评分较高、ECOG评分较高、LDH大于正常值的患者，而LMR/LDH（%）＜0.35%也更易于发生在临床分期较晚、有B症状、IPI评分较高、ECOG评分较高、LDH大于正常值的患者。Spearman相关分析显示，血清LDH和PET-CT扫描中的SUVmax有明显的正相关（P＜0.001）。K-M生存分析显示，高LMR组的PFS率及OS率均明显优于低LMR组（P＜0.05）,高LMR/LDH组的PFS率及OS率均明显优于低LMR/LDH组（P＜0.05）。多因素COX分析结果显示，LMR/LDH比单一LMR预测效力更好，为DLBCL患者的独立预后因素. 结论: 初诊时高LMR/LDH提示DLBCL患者具有更好的预后.

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