Research On The Correlation Between Lymphocyte-to-monocyte Ratio Combined With Carcinoembryonic Antigen And Prognosis Of Colorectal Cancer

Objective: To explore the relationship between preoperative lymphocyte-to-monocyte ratio combined with carcinoembryonic antigen(CEA)level and prognosis of patients with colorectal cancer,to provide basis for the prognosis of patien ts with colorectal cancer after surgery,and to guide the corresponding treatmen t and follow-up means,in order to improve the survival time and quality of li fe of patients with colorectal cancer.Methods: Ninety-three patients with colorectal cancer diagnosed by general surgery and treated surgically in Baotou Central Hospital from January 2012 to June 2014 were selected as subjects and followed up for 5 years.Their follow-up and clinical data were retrospectively analyzed.Receiver operating characteristic curve(ROC)was used to determine the optimal cut-off value of LMR.LMR and CEA were grouped by optimal cutoff and reference values,using Pearson ?2 test or Fisher's exact test were used to analyze the relationship between LMR and CEA in different groups and clinicopathological data of colorectal cancer patients.In univariate analysis,KaplanMeier method was used to calculate the cumulative survival rate and draw the survival curve,Log rank test was used to compare the survival rate.Cox proportional regression model was used to analyze the multiple factors to find out the independent risk factors affecting the prognosis of patients,and the hazard ratio(HR)of the independent risk factors was calculated.P < 0.05 indicated that the difference was statistically significant.Results:(1)By ROC curve analysis,the 5-year survival rate of colorectal cancer patients predicted by LMR before operation was 0.754.The best cutoff value was4.515.Whereby the enrolled cases were divided into two groups: high LMR group(LMR > 4.515,40 cases)and low LMR group(LMR?4.515,53 cases).(2)Preoperative low LMR was significantly associated with mortality(P < 0.05),and the mortality rate in the high LMR group was lower than that in the low LMR group.There was no significant difference in other clinicopathological data between groups(P > 0.05).Preoperative high CEA(CEA ? 3 ng/m L)was significantly associated with age,tumor size and mortality,with significant difference(P < 0.05),and the low CEA(CEA < 3 ng/m L)group had lower age ?70 years ratio,tumor size?5 cm ratio and mortality rate than the high CEA group.There was no significant difference in other clinicopathological data between groups(P > 0.05).(3)The results of univariate analysis on the survival of colorectal cancer patients showed that 11 observation indexes,including gender,age,LMR grade,CEA grade,pathological stage,tumor size,vascular tumor thrombus,depth of invasion,lymph node metastasis,distant metastasis,LMR combined with CEA,had an effect on the survival rate of patients,with statistical differences(P < 0.05).The survival time and survival rate of female patients,age < 70 years,LMR > 4.515,CEA < 3 ng/m L,low pathological stage,tumor < 5.0 cm,no vascular tumor thrombus,no nerve invasion,shallow invasion depth,less lymph node metastasis,no distant metastasis,LMR combined with CEA single positive and double negative patients were higher.The survival of patients with low LMR was significantly worse than that of patients with high LMR(P < 0.001).The survival of patients with high CEA was significantly worse than that of patients with low CEA(P < 0.05).The survival of LMR combined with CEA positive group was significantly worse than that of negative group(P <0.05),and the survival time of double positive group was the worst in the survival curve of LMR combined with CEA patients(P < 0.001).(4)The results of multivariate analysis showed that LMR combined with CEA was an independent risk factor for the prognosis of colorectal cancer patients(P < 0.05),and the probability of single positive death was 2.306 times higher than that of double negative death(HR = 2.306),and the probability of double positive death was 6.179 times higher than that of double negative death(HR = 6.179).Conclusion: Preoperative low LMR and high CEA can indicate the poor prognosis of colorectal cancer patients.Preoperative LMR combined with CEA was an independent risk factor affecting the prognosis of colorectal cancer patients,and double positive LMR combined with CEA indicate that the prognosis of colorectal cancer patients is the worst.