Monocyte-to-Lymphocyte Ratio in the Diagnosis of Lymphoma in Adult Patients

Naoko Kamiya; Yukiko Ishikawa; Kazuhiko Kotani; Shuji Hatakeyama; Masami Matsumura

doi:10.2147/IJGM.S357468

Monocyte-to-Lymphocyte Ratio in the Diagnosis of Lymphoma in Adult Patients

Int J Gen Med. 2022 Apr 20:15:4221-4226. doi: 10.2147/IJGM.S357468. eCollection 2022.

Authors

Naoko Kamiya¹, Yukiko Ishikawa¹, Kazuhiko Kotani², Shuji Hatakeyama^{1

3}, Masami Matsumura¹

Affiliations

¹ Division of General Internal Medicine, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan.
² Division of Community and Family Medicine, Center for Community Medicine, Jichi Medical University, Shimotsuke-shi, Tochigi, Japan.
³ Division of Infectious Diseases, Jichi Medical University Hospital, Shimotsuke-shi, Tochigi, Japan.

Abstract

Background: Lymphomas, including Hodgkin lymphoma and non-Hodgkin lymphoma, are one of the differentials for peripheral lymphadenopathy and are difficult to diagnose clinically. Biopsy is essential for diagnosing lymphoma, although it is invasive. Non-invasive methods are required to identify patients with suspected lymphoma who should undergo a biopsy. The relevance of the monocyte-to-lymphocyte ratio has recently been reported to be a useful diagnostic marker in children with lymphoma and a prognostic marker of various other diseases. This study aimed to determine the relevance of the monocyte-to-lymphocyte ratio in the diagnosis of lymphoma in adults.

Methods: The study included 246 adult outpatients (median age of 49.0 years) presenting with peripheral lymphadenopathy. The final diagnosis was determined by reviewing the medical records. We categorized all patients into either the lymphoma group or the non-lymphoma group. The lymphoma group included patients who underwent biopsy and were diagnosed with lymphoma by histopathology, while the non-lymphoma group included those diagnosed with disease excluding lymphoma. The monocyte-to-lymphocyte ratios were compared between the two groups.

Results: Of the participants, 33 (13.4%) were assigned to the lymphoma group. The median age of the lymphoma and non-lymphoma groups were 67.0 years (interquartile range [IQR] 55.5-75.5 years) and 46.0 years (IQR 36.0-61.0 years), respectively. The lymphocyte and monocyte levels showed no significant differences between the two groups individually. Nonetheless, the monocyte-to-lymphocyte ratio was significantly higher in the lymphoma group (median, 0.36; IQR, 0.24-0.73) than in the non-lymphoma group (median, 0.29; IQR, 0.21-0.43; P = 0.022), independent of lymph node diameter ≥ 1 cm and C-reactive protein levels.

Conclusion: This study suggests that the monocyte-to-lymphocyte ratio can be a helpful diagnostic marker for lymphoma in adults with peripheral lymphadenopathy when the etiology is unclear even after a medical interview and physical examination.

Keywords: diagnostic marker; lymphadenopathy; lymphoma; monocyte-to-lymphocyte ratio.

Grants and funding

This work was supported in part by the Foundation for Development of the Community (research grant). The funder had no role in the study design, data collection, data analysis, data interpretation, writing of the manuscript, or decision to submit the manuscript for publication.