Clinical and Surgical Sciences (Surgery), Royal Infirmary of Edinburgh, Edinburgh, UK.
HPB (Oxford). 2007;9(6):456-60. doi: 10.1080/13651820701774891.
Recognized prognostic factors for resected pancreatic ductal adenocarcinoma (PDAC) include tumour size, differentiation, resection margin involvement and lymph node metastases. A further prognostic factor of less certain significance is lymphocyte count. The aim of this study was to investigate whether preoperative lymphocyte count is a prognostic indicator in patients with PDAC.
Patients who had undergone a potentially curative pancreaticoduodenectomy (PD) for PDAC between 1998 and 2005 were analysed. Standard prognostic factors, preoperative lymphocyte count, preoperative neutrophil count and survival data were collected.
Of the 44 patients studied, univariate analysis identified predictors of a poor survival as lymph node status (node positive (+ve) 10.3 [5.4-20.9] months versus node negative (-ve) 14.2 [10.9-31.4] months; p=0.038), posterior resection margin invasion (margin +ve 7.0 [5.1-15.0] months versus margin -ve 13.1 [10.0-28.3] months; p=0.025) and lymphocyte count below the reference range (<1.5 x 10(9)/litre 8.8 [7.0-13.1] months versus > or = 1.5 x 10(9)/litre 14.3 [7.0-28.3] months; p=0.029). Low preoperative lymphocyte count (p=0.027) and posterior margin invasion (p=0.023) retained significance on multivariate analysis. Preoperative neutrophil to lymphocyte ratio was not a significant prognostic factor.
Preoperative lymphocyte count is a significant prognostic factor in patients with PDAC.
已被认可的用于预测可切除胰腺导管腺癌（PDAC）患者预后的因素包括肿瘤大小、分化程度、切缘状态和淋巴结转移情况。另一个具有一定预后意义但尚未明确的因素是淋巴细胞计数。本研究旨在探讨术前淋巴细胞计数是否为 PDAC 患者的一个预后指标。
回顾性分析了 1998 年至 2005 年间接受根治性胰十二指肠切除术（PD）治疗的 PDAC 患者的临床资料。收集了包括标准预后因素、术前淋巴细胞计数、术前中性粒细胞计数和生存数据。
44 例患者中，单因素分析发现不良预后的预测因素包括淋巴结状态（阳性 (+ve) 10.3 [5.4-20.9] 个月，阴性 (-ve) 14.2 [10.9-31.4] 个月；p=0.038）、后切缘侵犯（阳性 7.0 [5.1-15.0] 个月，阴性 13.1 [10.0-28.3] 个月；p=0.025）和淋巴细胞计数低于参考范围（<1.5 x 10(9)/升 8.8 [7.0-13.1] 个月，≥1.5 x 10(9)/升 14.3 [7.0-28.3] 个月；p=0.029）。多因素分析显示，低术前淋巴细胞计数（p=0.027）和后切缘侵犯（p=0.023）仍具有显著意义。术前中性粒细胞与淋巴细胞比值不是一个显著的预后因素。
术前淋巴细胞计数是 PDAC 患者的一个显著预后因素。
