| Objective: The purpose of this study was to investigate the relationship between LMR(lymphocyte to monocyte ratio)and prognostic total survival and non-progressive survival in patients with advanced gastric cancer,and to study the relationship between other clinical features,hematologic parameters and prognostic survival,and the correlation and LMR.A linear prediction model was established to provide reference for clinical treatment.Methods:From January 2009 to July 2017 322 patients with advanced gastric cancer in the first affiliated Hospital of China Medical University were selected and 182 patients were included in the study.Follow up by outpatient,telephone or hospital every 6months,the last time is October 2017.Total survival time(OS),defined as the interval of death caused by the diagnosis of recurrence and metastasis,and the progression-free survival time(PFS)defined as the time interval between the diagnosis of recurrence and metastasis and the progression of the disease.The cut-off point of the advanced patient was the last follow-up date,and the clinical characteristics,hematological analysis and other indexes were collected.The main end point of this study was OS,and the second was that PFS.LMR was divided into high LMR group(LMR > 3.326)and low LMR group(LMR ≤ 3.326).All data input into Excel tables,using SPSS16.0 statistical software Statistical analysis was carried out,and the measurement data were expressed by mean number of standard deviation,t test,X2 test(Fisher test),and P < 0.05 for statistical significance.The one year survival rate was calculated by life table method,and single factor analysis of the clinics and hematology indexes was carried out by COX proportional risk regression model.Analysis of statistical significance was included in multiple factor analysis(P < 0.05).Kaplan-Meier survival analysis was used to fit PFS and OS curves,and bilateral Log-rank test was used to compare the difference.Type A is tested internally by C-index for consistency and differentiation.Results: All patients in the study were followed up until October 1,2017 or died.The study included 182 patients with a median age of 57 years,127 men,55 women,112 patients who had undergone radical gastrectomy and who had recurred after surgery.70 patients were diagnosed as advanced patients.There were 91 cases of low LMR and 91 cases of high LMR.The median OS time was 7.2 months and the median PFS time was5.15 months.X2 test showed that pulmonary metastasis was correlated with LMR.There was a correlation between LMR and leukocyte(P =0.006),neutrophil(P < 0.001),lymphocyte(P < 0.001),monocyte(P < 0.001)and albumin(P = 0.032).Univariate analysis of Cox survival analysis in patients with advanced gastric cancer showed that age,previous radical gastrectomy and lymph node metastasis were correlated with total survival.The statistical indicators in univariate analysis were included in the multivariate analysis,and the results showed that Whether surgery and LMR(P=0.036,HR=0.699,95% CI 0.500-0.977)were independent prognostic factors for total survival.In progression-free survival analysis,single-factor analysis showed no correlation between age,surgery,white blood cell,and progression-free survival,but there was no significant correlation between LMR and PFS(P = 0.248,HR = 0.831,95 % CI0.606-1.138)and whether the procedure was an independent prognostic factor for PFS.Four items of statistical significance for OS were age,surgery,Lymph node metastasis and LMR were included in the model to make a clinical prognosis model.The higher the score of these indicators,the worse the prognosis and the lower the survival rate.Conclusion: The 1-year survival rate in patients with advanced gastric cancer with high LMR was higher than that in patients with low LMR.LMR ≤ 3.326 was an independent prognostic factor affecting the overall survival of patients with poor prognosis,but had no correlation with progressive survival.In the subgroup analysis,there was statistical difference in the total survival of the patients with high LMR and low LMR in the operation group,while there was no difference in the non-operative group,but there was no statistical difference in the progressive survival analysis between the operative group and the non-operative group. |
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