The Prognostic Value Of Preoperative Hematologic Markers In Early Stage Cutaneous Malignant Melanoma

Objective:Malignant melanoma(MM)evolves from the melanocytes at neuroectoderm.It is a very aggressive malignant tumor without special characteristic,and it has a high tendency of early metastasis through lymphatic and hematologic.It is insensitive to chemotherapy and radiotherapy.In recent years,the morbidity of MM rise continuously,the mortality is always staying at a high level.With the increase of therapies,it is critical to find an indicator which can predict the prognosis of MM and collect a therapy which is the most effective and also appropriate.The aim of this study was to explore the relationship between the preoperative blood indicators and the prognosis of the early stage MM patients.Methods:Clinicopathological data of 120 cutaneous MM patients who receive initial treatment and radical operation in the Cancer Hospital of Tianjin Medical University from January 2007 to May 2012 were obtained.Associations of the blood indicators with categorized clinical variables were analyzed by the Wilcoxon rank-sum test.Receiver Operating Characteristic(ROC)curve is used to determine the cutoff point of the blood indicators.Kaplan-Meier and COX’S proportional hazards regression model were utilized to analyse the prognostic significance of the blood indicators.Results:Patients whose tumour with ulceration have higher neutrophil-to-lymphocyte ratio(NLR)and basophilic granulocyte.Univariate analysis showed that NLR,platelet-to-ly mphocyte ratio(PLR),lymphocyte-to-monocyte ratio(LMR),neutrophil,lymphocyte,monocyte,lactic dehydrogenase(LDH),age,stage and ulceration were all risk factors of poor 5-year overall survival(P<0.05).The multivariate analysis identified PLR(HR=4.206,95%CI:1.654-10.696,P=0.003),stage(HR=7.670,95%CI:3.977-14.795,P<0.001)a nd ulceration(HR=1.931,95%CI:1.029-3.623,P=0.040)as independent risk factors predicting the prognosis of the MM patients.Conclusion:Stage,ulceration and PLR have correlation with the prognosis of the early stage cutaneous MM patients.Later stage,ulceration and higher PLR indicate a worse prognosis.Higher preoperative PLR can be used as a poor prognostic marker for the early stage MM patients.