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Academic Journal of Medicine & Health Sciences, 2024, 5(5); doi: 10.25236/AJMHS.2024.050510.

Lymphocyte-to-Monocyte Ratio: A Simple and Effective Inflammation Marker in Predicting Mortality of Non-Institutionalized Americans with Cancers


Lei Yang1, Xiaohe Sun2, Shuai Chen1, Hua Shao1

Corresponding Author:
Hua Shao

1The Second Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China

2Jiangsu Province Hospital of Chinese Medicine, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, Jiangsu, China


Cancer is a serious disease with a high mortality rate. In view of the urgent need of prognosis, the lymphocyte-to-monocyte ratio (LMR) may be a promising cancer marker, but the evidence is weak. Accordingly, we evaluated the clinical impact of LMR based on the Health and Nutrition Examination Survey (NHANES) data. An overall sample of 2363 cancer patients was studied. Based on the Cox proportional hazards model, we examined the relationship between LMR and all-cause mortality. The Kaplan-Meier (KM) analysis assessed the predictive power of LMR for cancer prognosis in comparison to Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR). In addition, extra subgroup analyses and sensitivity analyses were carried out to examine the robust of the outcomes. After accounting for multiple covariates, LMR was associated with mortality for all-causes among cancer patients. In Kaplan-Meier survival curves, mortality rate was significantly elevated among low-LMR group versus high-LMR group (Log rank test P < 0.001). Multiple regression analyses revealed the same result that LMR in continuous or categorical variables were respectively associated with the risk of all-cause mortality in participants with cancer (P <0.05). Further analyses were conducted on subgroups of age, gender, body mass index, baseline medical condition and extra sensitivity analyses, the results are still robust. In conclusion, an elevated LMR was associated with a lower mortality rate in patients with cancers. LMR may serve as a potential inflammatory predictor of cancer mortality prognosis, outperform NLR and PLR, as well as guide clinical treatment.


LMR, Mortality, Cancer Prognosis, Inflammation, NHANES

Cite This Paper

Lei Yang, Xiaohe Sun, Shuai Chen, Hua Shao. Lymphocyte-to-Monocyte Ratio: A Simple and Effective Inflammation Marker in Predicting Mortality of Non-Institutionalized Americans with Cancers. Academic Journal of Medicine & Health Sciences (2024), Vol. 5, Issue 5: 71-79. https://doi.org/10.25236/AJMHS.2024.050510.


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