ArticleBMC cancer2026
Prognostic value of pre-treatment serum CA19-9 and lymphocyte-to-monocyte ratio in HR+/HER2- breast cancer: a retrospective cohort study.
Article in BMC cancer, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundThe prognostic significance of carbohydrate antigen 19 − 9 (CA19-9) and the lymphocyte-to-monocyte ratio (LMR) in hormone receptor–positive/human epidermal growth factor receptor 2–negative (HR+/HER2-) breast cancer remains unclear. This study aimed to evaluate their value as pre-treatment prognostic markers.
methodsWe retrospectively analyzed 349 h+/HER2- breast cancer patients who underwent surgery between 2011 and 2012. Patients with other malignancies or incomplete follow-up were excluded. Serum CA19-9 levels and LMR were measured before any treatment, and optimal cut-offs were determined using receiver operating characteristic (ROC) curves.
resultsROC analysis identified cut-offs of 27.54 U/mL for CA19-9 and 5.34 for LMR. Patients with CA19-9 ≤ 27.54 U/mL had significantly longer OS, and patients with LMR > 5.34 also had significantly longer OS (P = 0.019 and P = 0.021, respectively). Multivariate Cox analysis identified N stage and high pre-treatment CA19-9 as independent predictors of OS, whereas LMR, age, tumor grade, Ki-67, menopausal status, and tumor size were not independently associated with OS. A combined risk score incorporating CA19-9 and LMR was associated with OS stratification within this cohort, with the low-risk group showing more favorable OS (P < 0.05). Nomogram analysis integrating CA19-9, LMR, and clinicopathologic factors showed moderate discrimination in internal validation.
conclusionsHigh pre-treatment CA19-9 was independently associated with worse overall survival, whereas the prognostic value of LMR was limited to univariate analysis. The combined assessment of CA19-9 and LMR may provide supplementary prognostic information, although its incremental value beyond established clinicopathologic factors appears limited and requires further validation in independent cohorts.
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