title: Prognostic value of the lymphocyte-to-monocyte ratio and other inflammatory markers in malignant pleural mesothelioma.
abstract: OBJECTIVE
  Inflammation plays a role in malignant pleural mesothelioma (MPM) prognosis and symptoms. We investigated the roles of the new and old inflammatory indexes and markers in MPM prognosis.
  
  
  METHODS
  Two hundred and ninety-two MPM patients (167 male and 125 female) were included in this retrospective study. Demographic parameters were collected from the patients' files. Kaplan-Meier curves and multivariate Cox regression analyses were used for the analysis of prognosis.
  
  
  RESULTS
  The mean age of the patients was 58.4 years. The mean survival time was 14.6 ± 13.0 months. Twenty-four potential prognostic factors associated with a poor outcome were calculated in the univariate analysis, and 16 potential prognostic factors were associated with a poor prognosis. These 16 potential prognostic factors were also analyzed in multivariate analysis. Multivariate analysis showed that increased age, stage 3-4 disease, the non-epithelial type, a low Karnofsky performance score, a high white blood cell count, and a low lymphocyte-to-monocyte ratio (LMR) were associated with a poor prognosis. The results of the multivariate analysis showed that a decreased LMR was associated with poor survival. Patients with LMR ≤2.6 had poor survival compared with those with LMR >2.6 (mean 9.6 vs. 17.0 months, respectively; p = 0.004).
  
  
  CONCLUSIONS
  LMR is an independent marker of prognosis in patients with MPM and is superior to the other inflammation-based markers. The inexpensive nature and easy reproducibility of the hemogram should encourage the use of the LMR in clinical practice.
authors.affiliation: Department of Chest Diseases, Medical School of Dicle University, Diyarbakir, Turkey.
authors.forename: Abdullah Cetin
authors.initials: AC
authors.lastname: Tanrikulu
authors.affiliation: Department of Chest Diseases, Medical School of Dicle University, Diyarbakir, Turkey. arahmanabakay@hotmail.com.
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Abakay
authors.affiliation: Department of Nuclear Medicine, Diyarbakir Education and Training Hospital, Diyarbakir, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Komek
authors.affiliation: Department of Chest Diseases, Medical School of Dicle University, Diyarbakir, Turkey.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Abakay
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000175:diagnosis*; D008175:Lung Neoplasms / Q000097:blood / Q000175:diagnosis*; D008214:Lymphocytes / Q000378:metabolism*; D008297:Male; D008654:Mesothelioma / Q000097:blood / Q000175:diagnosis*; D000086002:Mesothelioma, Malignant; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D015999:Multivariate Analysis; D011379:Prognosis; D012189:Retrospective Studies; D014421:Turkey; D055815:Young Adult
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor
keywords: Inflammation; Lymphocyte-to-monocyte ratio; Malignant mesothelioma; Prognosis