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 1 Department of Medical Oncology, The Third Affiliated Hospital of Harbin Medicial University, Harbin 150040, China 2 Department of Pathology, The Third Affiliated Hospital of Harbin Medical University, Harbin 150040, China 3 Logistics University of People’s Armed Police Force, Tianjin 300162, China Correspondence to: Qingyuan Zhang, email: wjxilywendy@126.com Keywords: lymphocyte-to-monocyte ratio (LMR), neutrophil-to-lymphocyte ratio (NLR), diffuse large B-cell lymphoma (DLBCL), tumor-associated macrophages, programmed cell death-1 (PD-1) Received: April 27, 2016 Accepted: December 06, 2016 Published: December 27, 2016 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.