Prognostic impact of preoperative lymphocyte-to-monocyte ratio in patients with colorectal cancer with special reference to myeloid-derived suppressor cells

Fukushima J Med Sci. 2018 Aug 29;64(2):64-72. doi: 10.5387/fms.2018-10. Epub 2018 Jul 14.

Abstract

Aims: We aimed to investigate the relationship of colorectal cancer prognosis and inflammatory parameters, including neutrophil-to-lymphocyte ratio (NLR) and lymphocyte-to-monocyte ratio (LMR), with reference to circulating myeloid-derived suppressor cells (MDSCs) in the current study.

Patients and methods: Thirty-five patients who underwent curative-intent surgery were enrolled. A receiver-operating characteristic curve (ROC) was used to assess the usefulness of candidates for prognostic factors. Recurrence-free survival (RFS) was calculated using the Kaplan-Meier method, and the candidates for prognostic factors were assessed by a Cox proportional hazard model.

Results: ROC curve analyses determined cutoff values for NLR and LMR as 2.9 and 2.4, respectively. The percentage of MDSCs in patients with LMR ≤ 2.4 was statistically higher than in those with LMR > 2.4 (p = 0.012). The patients with LMR ≤ 2.4 exhibited a statistically lower RFS than those with LMR > 2.4 (p = 0.008). These results were also observed in patients with stage II + III disease. LMR was an independent prognostic factor of RFS in colorectal cancer patients (hazard ratio: 7.757, 95% confidence interval: 1.462-41.152, p = 0.016).

Conclusion: Lower LMR was associated with poor prognosis in colorectal cancer patients; whereas, higher circulating MDSCs were observed in patients with lower LMR.

Keywords: colorectal cancer; lymphocyte-to-monocyte ratio; myeloid-derived suppressor cells; neutrophil-to-lymphocyte-ratio.

MeSH terms

  • Aged
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / mortality*
  • Female
  • Humans
  • Lymphocytes*
  • Male
  • Middle Aged
  • Monocytes*
  • Myeloid-Derived Suppressor Cells / physiology*
  • Neutrophils
  • Prognosis
  • Proportional Hazards Models