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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

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Abstract

Purpose

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).

Methods

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.

Results

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.

Conclusions

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.

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Abbreviations

AJCC:

American Joint Committee on Cancer

ALC:

Absolute lymphocyte count

AMC:

Absolute monocyte count

CI:

Confidence interval

DFS:

Disease-free survival

EAC:

Esophageal adenocarcinoma

EC:

Esophageal cancer

ESCC:

Esophageal squamous cell cancer

HR:

Hazard ratio

KPS:

Karnofsky performance score

LMR:

Lymphocyte-to-monocyte ratio

TAMs:

Tumor-associated macrophages

TME:

Tumor microenvironment

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, 440 Jiyan Road, Jinan, 250117, Shandong, China

    Yingming Zhu, Minghuan Li, Cong Bo, Xuemei Liu, Zhenxiang Li, Fen Zhao, Li Kong & Jinming Yu

  2. Department of Pathology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China

    Jianbo Zhang

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  1. Yingming Zhu
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  2. Minghuan Li
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  3. Cong Bo
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Zhu, Y., Li, M., Bo, C. et al. 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. Cancer Immunol Immunother 66, 343–354 (2017). https://doi.org/10.1007/s00262-016-1931-5

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