Cancer Immunology, Immunotherapy

, Volume 66, Issue 3, pp 343–354 | Cite as

Prognostic significance of the lymphocyte-to-monocyte ratio and the tumor-infiltrating lymphocyte to tumor-associated macrophage ratio in patients with stage T3N0M0 esophageal squamous cell carcinoma

  • Yingming Zhu
  • Minghuan Li
  • Cong Bo
  • Xuemei Liu
  • Jianbo Zhang
  • Zhenxiang Li
  • Fen Zhao
  • Li Kong
  • Jinming Yu
Original Article



We assessed the prognostic significance of, and the relationship between, the pretreatment lymphocyte-to-monocyte ratio (LMR) and the TILs/tumor-associated macrophages (TAMs) ratio, in patients with esophageal squamous cell carcinoma (ESCC) of pathological stage T3N0M0 (pT3N0M0).


A total of 220 newly diagnosed ESCC patients of stage pT3N0M0 who had not undergone neoadjuvant therapy were included. Densities of CD8+ TILs, CD4+ TILs, CD45RO+ TILs, and CD68+ TAMs were assessed by immunohistochemical staining of tissue microarray cores from all 220 pT3N0M0 ESCC patients (who underwent radical resection). Hematological biomarkers including lymphocyte and monocyte counts were obtained from routine preoperative blood test data, and the LMR and TILs/TAMs ratios calculated. Cutoff finder for survival prediction was plotted to find out the optimal cutoff point for each parameter.


The LMR and TILs/TAMs ratios were interrelated. On univariate analyses of data from the entire cohort, the LMR, CD45RO/CD68 ratio, and CD8/CD68 ratio were significantly associated with both OS and disease-free survival. Only the CD45RO/CD68 ratio was independently prognostic of survival on multivariate analysis.


The prognostic significance of the CD45RO/CD68 ratio was higher than that of the LMR. The CD45RO/CD68 ratio is a useful independent prognostic marker in patients with pT3N0M0 ESCC who have undergone complete resection without neoadjuvant therapy.


Esophageal squamous cell cancer Lymphocyte-to-monocyte ratio TILs Tumor-associated macrophages Survival 



American Joint Committee on Cancer


Absolute lymphocyte count


Absolute monocyte count


Confidence interval


Disease-free survival


Esophageal adenocarcinoma


Esophageal cancer


Esophageal squamous cell cancer


Hazard ratio


Karnofsky performance score


Lymphocyte-to-monocyte ratio


Tumor-associated macrophages


Tumor microenvironment



This research was supported by a grant from Natural Science Foundation of Shandong Province, China (Grant No. ZR2015HZ004).

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

Supplementary material

262_2016_1931_MOESM1_ESM.pdf (2.5 mb)
Supplementary material 1 (PDF 2593 kb)


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Yingming Zhu
    • 1
  • Minghuan Li
    • 1
  • Cong Bo
    • 1
  • Xuemei Liu
    • 1
  • Jianbo Zhang
    • 2
  • Zhenxiang Li
    • 1
  • Fen Zhao
    • 1
  • Li Kong
    • 1
  • Jinming Yu
    • 1
  1. 1.Department of Radiation Oncology, Shandong Cancer Hospital and InstituteShandong UniversityJinanChina
  2. 2.Department of Pathology, Shandong Cancer Hospital and InstituteShandong UniversityJinanChina

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