Absolutemonocyteandlymphocytecountprognosticscoreforpatientswithgastriccancer

摘要： AIM:Tomeasuretheprognosticsignificanceofabsolutemonocytecount/absolutelymphocytecountprognosticscore(AMLPS)inpatientswithgastriccancer.METHODS:Weretrospectivelyexaminedthecombinationofabsolutemonocytecount(AMC)andabsolutelymphocytecount(ALC)asprognosticvariablesinacohortof299gastriccancerpatientswhounderwentsurgicalresectionbetween2006and2013andwerefollowedatasingleinstitution.BothAMCandALCweredichotomizedintotwogroupsusingcut-offpointsdeterminedbyreceivingoperatorcharacteristiccurveanalysis.AnAMLPSwasgenerated,whichstratifiedpatientsintothreeriskgroups:lowrisk(bothlowAMCandhighALC),intermediaterisk(eitherhighAMCorlowALC),andhighrisk(bothhighAMCandlowALC).TheprimaryobjectiveofthestudywastovalidatetheimpactofAMLPSonbothdisease-freesurvival(DFS)andoverallsurvival(OS),andthesecondobjectivewastoassesstheAMLPSasanindependentprognosticfactorforsurvivalincomparisonwithknownprognosticfactors.RESULTS:Usingdatafromtheentirecohort,themostdiscriminativecut-offvaluesofAMCandALCselectedonthereceiveroperatingcharacteristiccurvewere672.4/μLand1734/μLforDFSandOS.AMLPSriskgroupsincluded158(52.8%)patientsinthelowrisk,128(42.8%)intheintermediate-risk,and13(4.3%)inthehigh-riskgroup.Withamedianfollowupof37.2mo(range:1.7-91.4mo),five-yearDFSratesinthelow-,intermediate-,andhigh-riskgroupswere83.4%,78.7%,and19.8%,respectively.AndfiveyearOSratesinthelow-,intermediate-,andhigh-riskgroupswere89.3%,81.1%,and14.4%,respectively.Onmultivariateanalysisperformedwithpatient-andtumor-relatedfactors,weidentifiedAMLPS,age,andpathologictumor-node-metastasisstageasthemostvaluableprognosticfactorsimpactingDFSandOS.CONCLUSION:AMLPSidentifiedpatientswithapoorDFSandOS,anditwasindependentofage,pathologicstage,andvariousinflammatorymarkers. （共9頁(yè)）