title: Prognostic significance of the lymphocyte-to-monocyte ratio in patients with malignant pleural mesothelioma.
abstract: OBJECTIVE
  Chronic inflammation plays a key role in the pathogenesis of malignant pleural mesothelioma (MPM) as a result of asbestos exposure. Several inflammation-based prognostic scores including the lymphocyte-to-monocyte ratio (LMR), Glasgow Prognostic Score (GPS), neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) reportedly predict survival in many malignancies, while the role of LMR in MPM remains unclear. The aim of this study was to evaluate the clinical value of LMR and to compare the prognostic value of these inflammation-based scores in predicting overall survival (OS) in MPM.
  
  
  METHODS
  One hundred and fifty patients with histologically proven MPM were included in this retrospective study. Kaplan-Meier curves and multivariate Cox-regression analyses were calculated for OS. The area under the receiver operating characteristics curve (AUC) was calculated to compare the discriminatory ability of each scoring system.
  
  
  RESULTS
  An elevated LMR was significantly associated with prolonged OS. Patients with LMR <2.74 had significantly poor survival compared with LMR ≥2.74 (median, 5.0 versus 14.0 months; p=0.000). The LMR consistently had a higher AUC value at 6 months (0.722), 12 months (0.712), and 24 months (0.670), compared with other scores. Multivariate analysis showed that the LMR was independently associated with OS.
  
  
  CONCLUSIONS
  The LMR is an independent prognostic marker for OS in patients with MPM and is superior to other inflammation-based prognostic scores with respect to prognostic ability.
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Tomoko
authors.initials: T
authors.lastname: Yamagishi
authors.affiliation: Department of Medical Oncology, Okayama Rosai Hospital, Okayama, Japan. Electronic address: nobufujimot@gmail.com.
authors.forename: Nobukazu
authors.initials: N
authors.lastname: Fujimoto
authors.affiliation: Department of Surgery, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nishi
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Miyamoto
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Naofumi
authors.initials: N
authors.lastname: Hara
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Asano
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Yasuko
authors.initials: Y
authors.lastname: Fuchimoto
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Sae
authors.initials: S
authors.lastname: Wada
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Kitamura
authors.affiliation: Department of Respiratory Medicine,Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Shinji
authors.initials: S
authors.lastname: Ozaki
authors.affiliation: Department of Internal Medicine, Okayama Rosai Hospital, Okayama, Japan.
authors.forename: Takumi
authors.initials: T
authors.lastname: Kishimoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000009:adverse effects; D014408:Biomarkers, Tumor / Q000032:analysis; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000473:pathology; D008175:Lung Neoplasms / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008654:Mesothelioma / Q000097:blood* / Q000473:pathology* / Q000628:therapy; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009000:Monocytes / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D014408:Biomarkers, Tumor; D001194:Asbestos
keywords: Asbestos; Lymphocyte-to-monocyte ratio; Malignant pleural mesothelioma; Prognostic score