Prognostic Significance of Lymphocyte to Monocyte Ratio in Gallbladder Carcinoma

Abstract Background: Increasing evidence indicates cancer-associated inflammatory biomarkers show great promise for predicting prognosis of cancer patients. The objective of this study aims to evaluate the prognostic significance of the lymphocyte-to-monocyte ratio in patients with gallbladder carcinoma. Methods: Receiver operating characteristic curves was used to determine cut-off values for the LMR at detecting death. The primary outcome was overall survival, which was estimated by the Kaplan-Meier method. Univariate survival analysis was performed using a log rank test. Multivariate analysis using the Cox regression proportional hazard model was performed to identify the factors associated with the prognosis.A retrospective cohort of 80 GBC followed by operation was recruited between March 2008 and August 2014 at the Qingdao Municipal Hospital. Counts for absolute lymphocytes and monocytes were obtained and used to calculate the LMR.Results: For the LMR, the area under the ROC curve was 0.675 (95%CI: :0.530-0.820).The cut-off value for the LMR was determined to be 4.62. Patients in the high-LMR group experienced significant improvements in median survival time compared with patients in the low-LMR group(P = 0.03).The univariate analysis demonstrated that LMR, differentiation degree, TNM stage,CA199, CEA, Resection margin and operative methods were associated with overall survival (P < 0.05). The multivariate analysis identified that Differentiation grade , TNM stage, and CRP as independent prognostic factors in the patients with GBC(P <0.05). Conclusion: Our study demonstrated that LMR is closely correlated with GBC prognosis and could be useful for the evaluation of prognosis of patients with GBC.