Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2017 Jan 17;8(3):5414-5425.
doi: 10.18632/oncotarget.14289.

Lymphocyte-to-monocyte ratio is associated with prognosis of diffuse large B-cell lymphoma: correlation with CD163 positive M2 type tumor-associated macrophages, not PD-1 positive tumor-infiltrating lymphocytes

Jingxuan Wang  1 , Kun Gao  1 , Wanting Lei  1 , Lina Dong  1 , Qijia Xuan  1 , Meiyan Feng  2 , Jinlu Wang  1 , Xiangnan Ye  1 , Tuan Jin  1 , Zhongbai Zhang  3 , Qingyuan Zhang  1
Affiliations

Lymphocyte-to-monocyte ratio is associated with prognosis of diffuse large B-cell lymphoma: correlation with CD163 positive M2 type tumor-associated macrophages, not PD-1 positive tumor-infiltrating lymphocytes

Jingxuan Wang et al. Oncotarget. .

Abstract

The research aims to examine the prognostic value of the lymphocyte-to-monocyte ratio (LMR), neutrophil-to- lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in diffuse large B-cell lymphoma (DLBCL). The relation of these hematologic indicators to poor antitumor immunity and prognosis must be investigated. Clinicopathologic data and survival information of 355 patients with DLBCL was retrospectively analyzed. Univariate analysis revealed that lower LMR (<2.71), higher NLR (≥2.81), CD163+ M2 tumor-associated macrophages (TAM) content ≥9.5% and programmed cell death 1 (PD-1)+ tumor-infiltrating lymphocytes (TILs) content < 4.5 cells per high power field(HPF) were significantly related to unfavorable overall survival (OS) and progression free survival (PFS). When considering the prognostic indexes of IPI, multivariate analysis confirmed that LMR of <2.71 and CD163+ M2 TAM content ≥9.5% significantly affected the prognosis of DLBCL. Spearman correlation test showed LMR was negatively correlated with CD163+ M2 TAM content. However, there were no correlation was found between LMR and PD-1+ TIL as well as between NLR and PD-1+ TIL content. These results indicated that decreased LMR lead to a weak anti-tumor immunity and could be used as a bad prognosis biomarker of DLBCL.

Keywords: diffuse large B-cell lymphoma (DLBCL); lymphocyte-to-monocyte ratio (LMR); neutrophil-to-lymphocyte ratio (NLR); programmed cell death-1 (PD-1); tumor-associated macrophages.

PubMed Disclaimer

Conflict of interest statement

CONFLICTS OF INTEREST

No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1. ROC curves analysis for all prognostic factors at diagnosis
A. ALC (absolute lymphocyte count ). B. AMC (absolute monocyte count). C. LMR (lymphocyte-to-monocyte ratio). D. NLR (Neutrophil-to-lymphocyte ratio). E. CD163+ M2 TAM (tumor-associated macrophages). F. PD-1+ TILs (tumor infiltrating lymphocytes).
Figure 2
Figure 2. Immunohistochemical staining of tumor-associated macrophages (TAM) and PD-1+ tumor-infiltrating lymphocytes(TILs) in diffuse large B-cell lymphoma (100×HPF and 400×HPF)
A. Low infiltration of CD163+ M2 TAM (<9.5%). B. High infiltration of CD163+ M2 TAM (≥9.5%). C. Low infiltration of PD-1+ TILs (<4.5cells/HPF). D. High infiltration of PD-1+ TILs (≥4.5cells/HPF).
Figure 3
Figure 3. Kaplan-Meier curves of OS for patients by clinical and pathological characteristics
A. ALC (absolute lymphocyte count). B. AMC (absolute monocyte count). C. LMR (lymphocyte-to-monocyte ratio). D. NLR (Neutrophil-to-lymphocyte ratio). E. CD163+ M2 TAM (tumor-associated macrophages). F. PD-1+ TILs (tumor infiltrating lymphocytes).
Figure 4
Figure 4. Kaplan-Meier curves of PFS for patients by clinical and pathological characteristics
A. ALC (absolute lymphocyte count). B. AMC (absolute monocyte count). C. LMR (lymphocyte-to-monocyte ratio). D. NLR (Neutrophil-to-lymphocyte ratio). E. CD163+ M2 TAM (tumor-associated macrophages). F. PD-1+ TILs (tumor infiltrating lymphocytes).
Figure 5
Figure 5. Spearman correlation between peripheral blood monocyte count, lymphocyte-to-monocyte ratio and the number of CD163+ M2 TAM (tumor-associated macrophages)
A. monocyte count. B. LMR (lymphocyte-to-monocyte ratio).
See this image and copyright information in PMC

References

    1. Friedberg JW. New strategies in diffuse large B-cell lymphoma: translating findings from gene expression analyses into clinical practice. Clin Cancer Res.2012; 17:6112–6117. - PMC - PubMed
    1. Project TIN-HsLPF. A predictive model for aggressive non-Hodgkin's lymphoma. The International Non-Hodgkin's Lymphoma Prognostic Factors Project. N Engl J Med.1993; 329:987–994. - PubMed
    1. Sehn LH, Berry B, Chhanabhai M, Fitzgerald C, Gill K, Hoskins P, Klasa R, Savage KJ, Shenkier T, Sutherland J, Gascoyne RD, Connors JM. The revised International Prognostic Index (R-IPI) is a better predictor of outcome than the standard IPI for patients with diffuse large B-cell lymphoma treated with R-CHOP. Blood. 2007;109:1857–1861. - PubMed
    1. Lenz G, Wright G, Dave SS, Xiao W, Powell J, Zhao H, Xu W, Zan B, Goldschmidt N, Iqbal J, Vose J, Bast M. Stromal gene signatures in large-B-cell lymphomas. N Engl J Med. 2008;359:2313–2323. - PMC - PubMed
    1. Monti S, Savage KJ, Kutok JL, Feuerhake F, Kurtin P, M+ihm M, Wu B, Pasqualucci L, Neuberg D, Aguiar RCT, Cin PD, Ladd C, Pinkus GS, et al. Molecular profiling of diffuse large B-cell lymphoma identifies robust subtypes including one characterized by host inflammatory response. Blood. 2005;105:1851–1861. - PubMed

MeSH terms