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已发表论文
低淋巴细胞/单核细胞比值预测颅内动脉粥样硬化性狭窄中的斑块不稳定和卒中复发
Authors Wu XB , Guo X, Liu CC, Liu YA, Huang ZR, Huang LX , Li QJ, Xu HX, Luo B, Wang SW
Received 5 November 2025
Accepted for publication 27 January 2026
Published 4 February 2026 Volume 2026:19 577715
DOI https://doi.org/10.2147/JIR.S577715
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Ning Quan
Xiao-Bing Wu,1,2,* Xin Guo,1,2,* Chi-Chen Liu,1,2,* Yi-Ao Liu,2 Zhong-Run Huang,1 Li-Xin Huang,3 Qing-Jian Li,4 Hui-Xin Xu,4 Bin Luo,2 Sheng-Wen Wang1
1Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 3Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 4Department of Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Bin Luo, Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, 3025 Shennan Middle Road, Shenzhen, 518033, People’s Republic of China, Email luob9@mail.sysu.edu.cn Sheng-Wen Wang, Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, Guangdong, 510120, People’s Republic of China, Email wangshw9@mail.sysu.edu.cn
Background and Purpose: While our previous cross-sectional study linked the lymphocyte-to-monocyte ratio (LMR) to symptomatic ICAS and plaque inflammation, its prospective value for predicting stroke recurrence remained unexplored. This study aimed to validate the association between LMR and plaque instability in a larger cohort and, critically, to determine whether baseline LMR predicts future ischemic events.
Methods: We prospectively enrolled adult patients with radiologically confirmed ICAS from April 2018 to July 2024 at our tertiary cerebrovascular center. Comprehensive datasets, including clinical characteristics, laboratory markers (LMR and full inflammatory profiles), and neuroimaging features, were systematically collected and analyzed. Hematologic markers were compared between patients with ICAS with and without plaque enhancement and between those with and without symptoms. Receiver operating characteristic analysis was used to assess the discriminative value of LMR for plaque instability and determine optimal cutoff points. A follow-up was conducted to record stroke recurrence and evaluate the predictive role of baseline LMR.
Results: We included 132 patients with confirmed ICAS. LMR emerged as an independent predictor of both plaque enhancement and symptomatic ICAS. An LMR cutoff of 4.0 effectively distinguished symptomatic from asymptomatic plaques. In 120 patients with ICAS with follow-up data, those with LMR of ≤ 4.0 had significantly higher recurrence (32.1% vs 15.6%, P = 0.026) and shorter median recurrence time (P = 0.049) than those with an LMR of > 4.0. Kaplan–Meier analysis showed a significantly lower recurrence-free survival rate in the LMR ≤ 4.0 group than in the LMR > 4.0 group (P = 0.011).
Conclusion: A low LMR is associated with plaque instability in ICAS, and an LMR ≤ 4.0 may serve as a practical and accessible hematologic marker that could help identify patients at increased short-term risk of stroke recurrence.
Keywords: intracranial atherosclerotic stenosis, lymphocyte-to-monocyte ratio, plaque enhancement, plaque instability, follow up, recurrence
1Department of Neurosurgery, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 2Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, People’s Republic of China; 3Department of Neurosurgery, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, People’s Republic of China; 4Department of Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, People’s Republic of China
*These authors contributed equally to this work
Correspondence: Bin Luo, Department of Neurosurgery, The Eighth Affiliated Hospital, Sun Yat-Sen University, 3025 Shennan Middle Road, Shenzhen, 518033, People’s Republic of China, Email luob9@mail.sysu.edu.cn Sheng-Wen Wang, Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, Guangdong, 510120, People’s Republic of China, Email wangshw9@mail.sysu.edu.cn
Background and Purpose: While our previous cross-sectional study linked the lymphocyte-to-monocyte ratio (LMR) to symptomatic ICAS and plaque inflammation, its prospective value for predicting stroke recurrence remained unexplored. This study aimed to validate the association between LMR and plaque instability in a larger cohort and, critically, to determine whether baseline LMR predicts future ischemic events.
Methods: We prospectively enrolled adult patients with radiologically confirmed ICAS from April 2018 to July 2024 at our tertiary cerebrovascular center. Comprehensive datasets, including clinical characteristics, laboratory markers (LMR and full inflammatory profiles), and neuroimaging features, were systematically collected and analyzed. Hematologic markers were compared between patients with ICAS with and without plaque enhancement and between those with and without symptoms. Receiver operating characteristic analysis was used to assess the discriminative value of LMR for plaque instability and determine optimal cutoff points. A follow-up was conducted to record stroke recurrence and evaluate the predictive role of baseline LMR.
Results: We included 132 patients with confirmed ICAS. LMR emerged as an independent predictor of both plaque enhancement and symptomatic ICAS. An LMR cutoff of 4.0 effectively distinguished symptomatic from asymptomatic plaques. In 120 patients with ICAS with follow-up data, those with LMR of ≤ 4.0 had significantly higher recurrence (32.1% vs 15.6%, P = 0.026) and shorter median recurrence time (P = 0.049) than those with an LMR of > 4.0. Kaplan–Meier analysis showed a significantly lower recurrence-free survival rate in the LMR ≤ 4.0 group than in the LMR > 4.0 group (P = 0.011).
Conclusion: A low LMR is associated with plaque instability in ICAS, and an LMR ≤ 4.0 may serve as a practical and accessible hematologic marker that could help identify patients at increased short-term risk of stroke recurrence.
Keywords: intracranial atherosclerotic stenosis, lymphocyte-to-monocyte ratio, plaque enhancement, plaque instability, follow up, recurrence