Comparison of inflammation nutrition-related scores as predictors in patients with unresectable advanced pancreatic cancer

Abstract

Background: Neutrophil to lymphocyte ratio (NLR) and mGPS (modified Glasgow Prognostic Score) are known as indices reflecting the inflammatory state. In addition, utility as prognostic predictors for various carcinomas has been reported.We examined the relationship of these inflammation/nutrition-related prognostic scores in unresectable advanced pancreatic cancer and examined its usefulness. Method: Patient (n=58) who had undergone treatment in our department for unresectable pancreatic cancer from 2003 to 2017(male:female = 38:20, average age 69.7 years old). Gastro-jejnostomy was 27 cases, open laparotomy wsa 6 cases, Colostomy was 3 cases, and 4 other cases. 18 cases were non-surgical treatment. 58cases were divided into two groups. ① high NLR group with NLR≧ 3.0 and ② low NLR group with NLR<3.0. As the evaluation of the general condition, we used nutritional risk index (NRI=10.7xAlb(g/dL)+0.0039×TLC (/mm3)+0.11×Zn (μg/dL)-0.044×age), Onodera's prognostic nutrition index (PNI), CONUT and mGPS. For mGPS, group A is normal pattern. Group B is usually malnourished. Group C is a cancer cachexia preliminary group. Group D was cancer cachexia. Result: In CONUT score, Nomal:8, Mild:30, Moderate:19, High:1. mGPS Group A 19, Group B 15, Group C 11, Group D 13. In relation to the prognosis, a significant difference was found between CONUT (Nomal / Mild vs Moderate / High) and mGPS (Group A vs. BCD group) in the low NLR group (p< 0.05). No significant difference was observed in the high NLR group. Conclusion: It was suggested that NLR, mGPS and CONUT Score are important factors regulating prognosis.