scholarly journals Prognostic Factors in Resected Pancreatic Ductal Adenocarcinoma: Is Neutrophil-Lymphocyte Ratio a Useful Marker?

2021 ◽  
Author(s):  
Ignacio Guillermo Merlo ◽  
Victoria Ardiles ◽  
Rodrigo Sanchez-Clariá ◽  
Eugenia Fratantoni ◽  
Eduardo de Santibañes ◽  
...  
Keyword(s):  
Overall Survival ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Adjuvant Treatment ◽  
Tumor Size ◽  
Pancreatic Resection ◽  
Perineural Invasion ◽  
Undifferentiated Carcinoma ◽  
Ductal Adenocarcinoma ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Background: The aim of this study is to analyze the role of neutrophil-lymphocyte ratio and its variation pre and post-operatively (delta NLR) in overall survival after pancreatectomy for pancreatic ductal adenocarcinoma at a single centre and to identify factors associated with overall survival.Methods: A retrospective study of consecutive patients undergoing pancreatic resection due to PDAC or undifferentiated carcinoma from January 2010 to January 2020 was performed. Association between evaluated factors and overall survival were analyzed using a log-rank test and Cox proportional hazard regression model.Results: Overall, 242 patients underwent complete pancreatic resection for PDAC or undifferentiated carcinoma. OS was 22.8 months (95% CI: 19.5-29) and survival rates at 1, 3 and 5 years were 72%, 32.5% and 20.8% respectively. NLR and delta NLR were not significantly associated with survival (HR=1.14, 95%CI: 0.77-1.68, p=0.5). Lymph node ratio was significantly associated (HR=1.66, 95%CI: 1.21-2.26, p=0.001) in the bivariate analysis. In multivariable analysis the only factors that were significantly associated with survival were perineural invasion (HR=1.94, 95%CI: 1.21-3.14, p=0.006), surgical margin (HR=1.83, 95%CI: 1.10-3.02, p=0.019), tumor size (HR=1.01, 95%CI: 1.003-1.027, p=0.16), postoperative CA 19-9 level (HR=1.001, p<0.001), and completion of adjuvant treatment (HR=0.53, 95%CI: 0.35-0.8, p=0.002).Conclusion: Neutrophil-lymphocyte ratio and delta NLR were not associated with overall survival in this cohort. Risk factors such as perineural invasion, surgical margins, CA19-9 level and tumor size showed worse survival in this study, whereas completing adjuvant treatment was a protective factor.

Preoperative platelet to lymphocyte ratio predicts outcome of patients with pancreatic ductal adenocarcinoma after pancreatic resection

Surgery ◽  
2015 ◽  
Vol 158 (2) ◽  
pp. 360-365 ◽  
Author(s):  
Yoshihiro Shirai ◽  
Hiroaki Shiba ◽  
Taro Sakamoto ◽  
Takashi Horiuchi ◽  
Koichiro Haruki ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Pancreatic Resection ◽  
Ductal Adenocarcinoma ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio

scholarly journals Neutrophil–lymphocyte ratio (NLR) was associated with prognosis and immunomodulatory in patients with pancreatic ductal adenocarcinoma (PDAC)

2020 ◽  
Vol 40 (6) ◽  
Author(s):  
Zi-jun Xiang ◽  
Tao Hu ◽  
Yun Wang ◽  
Hao Wang ◽  
Lin Xu ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Surgical Resection ◽  
Immune Cells ◽  
Prognostic Value ◽  
Roc Curves ◽  
T Cell Subsets ◽  
Ductal Adenocarcinoma ◽  
Survival Prediction ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio

Abstract Although the oncological outcomes in patients with pancreatic ductal adenocarcinoma (PDAC) have markedly improved over the past decade, the survival prediction is still challenging. The aim of this study was to investigate the prognostic value of neutrophil–lymphocyte ratio (NLR) and analyze the relationship of between the NLR and immune cells phenotypes in patients with PDAC. Sixty-seven consecutive patients with PDAC were recruited in this study. Life-table estimates of survival time were calculated according to the Kaplan and Meier methodology. The phenotypic T cells subclasses were evaluated by flow cytometry. All the 67 patients in this study were treated with surgical resection and among them, 46 patients received adjuvant chemotherapy. Receiver operating characteristic (ROC) curves analysis was performed to compare prognostic value of NLR with CA199. We found that the Harrell's area under ROC (AUROC) for the NLR to predict overall survival (OS) (0.840; 95% CI, 0.766–0.898) was significantly higher than that of the CA199 levels. After that we stratified all patients into NLR &gt; 2.5 (n = 42) and NLR ≤ 2.5 (n = 25) groups according to the OS of patients with PDAC. Survival analysis showed that patients with NLR ≤ 2.5 had significantly favorable OS and progressive free survival (PFS) compared with patients with NLR &gt; 2.5. The CD3+ and CD8+/CD28+ T cell subsets were significantly increased in patients with NLR ≤ 2.5 (P&lt;0.05), while the CD8+/CD28- and CD4+/CD25+ cell subsets were significantly decreased in patients with NLR ≤ 2.5 (P&lt;0.05). In conclusion, a high NLR value independently predicts poor survival in patients with PDAC after surgical resection. The NLR was closely related with immune cells phenotypes The NLR may help oncologists evaluate outcomes of patients received surgical resection and chemotherapy to choose alternative therapies for patients with high NLR value.

Elevated neutrophil/lymphocyte ratio is a major predictor of survival in advanced pancreatic ductal adenocarcinoma patients

Pancreatology ◽  
2014 ◽  
Vol 14 (3) ◽  
pp. S84-S85 ◽  
Author(s):  
Matteo Piciucchi ◽  
Roberto Valente ◽  
Giulia Zerboni ◽  
Daniele Romanello ◽  
Marianna Signoretti ◽  
...  
Keyword(s):  
Pancreatic Ductal Adenocarcinoma ◽  
Ductal Adenocarcinoma ◽  
Neutrophil Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
Major Predictor

scholarly journals A novel lncRNA PTTG3P/miR-132/212-3p/FoxM1 feedback loop facilitates tumorigenesis and metastasis of pancreatic cancer

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Wenyu Liu ◽  
Jian Tang ◽  
Huiqing Zhang ◽  
Fanyang Kong ◽  
Huiyun Zhu ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Overall Survival ◽  
Experimental Evidence ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Pituitary Tumor ◽  
Feedback Loop ◽  
Diagnostic Marker ◽  
Ductal Adenocarcinoma ◽  
Microrna Sponge

AbstractPseudogene pituitary tumor-transforming 3 (PTTG3P) is emerging as a key player in the development and progression of cancer. However, the biological role and clinical significance of PTTG3P in pancreatic ductal adenocarcinoma (PDAC) remain unclear. Here, we found that PTTG3P was significantly upregulated in PDAC tissues. Elevated PTTG3P expression correlated with larger tumor size and worse differentiation, and reduced overall survival. Bioinformatics and experimental evidence revealed that PTTG3P promoted malignant phenotypes and FoxM1 signaling pathway in PDAC cells. Mechanistically, PTTG3P functions as a microRNA sponge to positively regulate the expression of FoxM1 through sponging miR-132/212-3p. Moreover, it showed that FoxM1 transcriptionally activated PTTG3P expression, thus forming a feedback loop to promote the aggressiveness of PDAC cells. Taken together, our findings suggest that PTTG3P promotes PDAC progression through PTTG3P/miR-132/212-3p/FoxM1 feedforward circuitry and it may serve as a promising diagnostic marker or target for treatment in PDAC patients.

scholarly journals Significance of Frailty in Prognosis After Surgery in Patients with Pancreatic Ductal Adenocarcinoma

2020 ◽  
Author(s):  
Shinichiro Yamada ◽  
Mitsuo Shimada ◽  
Yuji Morine ◽  
Satoru Imura ◽  
Tetsuya Ikemoto ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Pancreatic Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Ductal Adenocarcinoma ◽  
Albumin Concentration ◽  
Tumor Diameter ◽  
Neutrophil Lymphocyte Ratio

Abstract Background: Frailty is an important consideration for older patients undergoing surgery. We aimed to investigate whether frailty could be prognostic factor in patients with pancreatic ductal adenocarcinoma who underwent pancreatic resection.Methods: One hundred and twenty patients who underwent pancreatic resection for pancreatic ductal adenocarcinoma were enrolled. Frailty was defined as a clinical frailty scale score ≥4. Patients were divided into frailty (n = 29) and non-frailty (n=91) groups, and clinicopathological factors were compared between two groups. Results: The frailty group showed an older age, lower serum albumin concentration, lower prognostic nutritional index, larger tumor diameter, and higher rate of lymph node metastasis than the non-frailty group (p < 0.05). Neutrophil–lymphocyte ratio and modified Glasgow prognostic score tended to be higher in the frailty group. Cancer-specific and disease-free survival rates were significantly poor in the frailty group (p < 0.05). With a multivariate analysis, frailty was an independent prognostic factor of cancer-specific survival.Conclusions: Frailty can predict the prognosis of patients with pancreatic ductal adenocarcinoma who undergo pancreatic resection.

DPC4/Smad4 Expression and Outcome in Pancreatic Ductal Adenocarcinoma

2002 ◽  
Vol 20 (23) ◽  
pp. 4531-4542 ◽  
Author(s):  
Andrew V. Biankin ◽  
Adrienne L. Morey ◽  
C.-Soon Lee ◽  
James G. Kench ◽  
Sandra A. Biankin ◽  
...  
Keyword(s):  
Cell Cycle ◽  
Prognostic Factors ◽  
Cell Signaling ◽  
Cyclin D1 ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Tumor Size ◽  
Perineural Invasion ◽  
Ductal Adenocarcinoma ◽  
Aberrant Expression ◽  
Smad4 Expression

PURPOSE: Prognostic indicators in pancreatic cancer (PC) are poorly defined and difficult to quantify preoperatively, hence they may lead to inappropriate patient selection for treatment. We examined the protein expression of key cell-cycle regulatory and cell-signaling molecules that occur at high frequency in PC and assessed their relationship to clinicopathologic parameters, response to operative resection, and outcome.PATIENTS AND METHODS: We identified 348 patients with pancreatic ductal adenocarcinoma and assessed the influence of reported clinicopathologic prognostic factors and the expression of the cell-cycle regulatory genes p21WAF1/CIP1(CDKN1A), cyclin D1 (CCND1), p53, and p16INK4A(CDKN2) and the cell-signaling molecule DPC4/Smad4 (MADH4) using immunohistochemistry in a subgroup of 129 patients.RESULTS: Independent prognostic factors in resected patients were tumor size greater than 45 mm (P = .0015), involvement of surgical margins (P < .0001), and perineural invasion (P = .014). Loss of DPC4/Smad4 expression cosegregated with resectability (P < .0001) and was associated with improved survival after resection (P < .0001), whereas resection did not improve survival in patients whose tumor expressed DPC4/Smad4 (P = .5). Aberrant expression of p21WAF1/CIP1, cyclin D1, p53, or p16INK4Awas not associated with a difference in survival.CONCLUSION: Tumor size (> 45 mm), resection margin involvement, and perineural invasion were independent prognostic factors. Preoperative assessment of DPC4/Smad4 expression has potential as a prognostic indicator in patients with PC since resection did not benefit those patients whose cancers expressed DPC4/Smad4 and accurate assessment of DPC4/Smad4 expression, unlike tumor size, margin status, and perineural invasion, does not require resection.

scholarly journals Significance of frailty in prognosis after surgery in patients with pancreatic ductal adenocarcinoma

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Shinichiro Yamada ◽  
Mitsuo Shimada ◽  
Yuji Morine ◽  
Satoru Imura ◽  
Tetsuya Ikemoto ◽  
...  
Keyword(s):  
Prognostic Factor ◽  
Pancreatic Ductal Adenocarcinoma ◽  
Pancreatic Resection ◽  
Prognostic Score ◽  
Glasgow Prognostic Score ◽  
Disease Free Survival ◽  
Ductal Adenocarcinoma ◽  
Albumin Concentration ◽  
Tumor Diameter ◽  
Neutrophil Lymphocyte Ratio

Abstract Background Frailty is an important consideration for older patients undergoing surgery. We aimed to investigate whether frailty could be a prognostic factor in patients with pancreatic ductal adenocarcinoma who underwent pancreatic resection. Methods One hundred and twenty patients who underwent pancreatic resection for pancreatic ductal adenocarcinoma were enrolled. Frailty was defined as a clinical frailty scale score ≥4. Patients were divided into frailty (n = 29) and non-frailty (n=91) groups, and clinicopathological factors were compared between the two groups. Results The frailty group showed an older age, lower serum albumin concentration, lower prognostic nutritional index, larger tumor diameter, and higher rate of lymph node metastasis than the non-frailty group (p < 0.05). Neutrophil–lymphocyte ratio and modified Glasgow prognostic score tended to be higher in the frailty group. Cancer-specific and disease-free survival rates were significantly poor in the frailty group (p < 0.05). With a multivariate analysis, frailty was an independent prognostic factor of cancer-specific survival. Conclusions Frailty can predict the prognosis of patients with pancreatic ductal adenocarcinoma who undergo pancreatic resection.

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