Abstract
Multiple cancers arise from sites of infection, chronic irritation, and inflammation. It has been widely accepted that pancreatic cancer is an inflammation-driven cancer. In this study, we investigated the application value of systemic inflammatory markers, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), in the prediction of chemotherapy response and prognosis in patients with late pancreatic cancer. 122 patients with inoperable pancreatic cancers were included and separated into two groups according to median values of NLR or PLR (NLR low:<3.81 or NLR high:≥3.81, and PLR low:<142.14 or PLR high≥142.14, respectively). Baseline NLR and PLR levels were significantly higher in pancreatic cancer patients compared with the healthy subjects. Neither of the baseline NLR or PLR levels could predict outcomes. Patients with low baseline level of NLR, but not PLR, had better responses to chemotherapy. Changes in NLR, but not PLR levels, were associated with the therapeutic efficacy. Patients who stayed in or dropped into the low NLR level subgroup after first-line chemotherapy had better responses, comparing to those stayed in or jumped into the high NLR level group. No similar results could be observed when the PLR level was investigated. Therefore, NLR is a more sensitive biomarker than PLR in the prediction of chemotherapy response of patients.
Highlights
Pancreatic cancer is an extremely malignant solid cancer with a collective 1-year survival of just 26%, and 5-year survival less than 5%
We investigated the application value of systemic inflammatory markers, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), in the prediction of chemotherapy response and prognosis in patients with late pancreatic cancer. 122 patients with inoperable pancreatic cancers were included and separated into two groups according to median values of NLR or PLR (NLR low:< 3.81 or NLR high:≥3.81, and PLR low:
Pancreatic cancer patients had a higher baseline PLR level comparing with the controls (P
Summary
Pancreatic cancer is an extremely malignant solid cancer with a collective 1-year survival of just 26%, and 5-year survival less than 5%. Almost all of the patients have lost the chance of surgery at the time of diagnosis. Even for those who received surgery, they might suffer from recurrence or metastasis. Chemotherapy is still one of the major treatments for pancreatic cancer [1] [2] [3]. Systemic inflammatory response (SIR) is reported to be closely related to outcomes in many cancers, including pancreatic cancer [4]. The quantifications of these hematological parameters have been analyzed as markers of SIR in various malignant tumors, including pancreatic cancer [6, 7]
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