Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
Department of Neonatology, Children's Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China (mainland).
Med Sci Monit. 2017 Nov 23;23:5574-5588. doi: 10.12659/msm.907182.
BACKGROUND The aim of this study was to evaluate the predictive and prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in pancreatic neuroendocrine tumor (PNET) patients undergoing potentially curative resection. MATERIAL AND METHODS A retrospective review of 172 patients with PNETs was conducted. Kaplan-Meier curves and multivariate Cox proportional models were used to calculate overall survival (OS) and disease-free survival (DFS). The predictive performance of the NLR was compared with other inflammation-based scores and conventional stratification systems using receiver operating characteristic (ROC) curve analysis. RESULTS Elevated NLR and PLR were both associated with advanced AJCC stage and high grade. In the univariate analysis, elevated NLR and PLR were both significantly associated with decreased OS and DFS. In the multivariate analysis, the preoperative NLR, but not the PLR, was an independent risk factor for OS (HR=4.471, 95% CI 1.531-13.054, p=0.006) and DFS (HR=2.531, 95% CI 1.202-5.329, p=0.015). The discriminatory capability of the NLR was superior to that of other inflammation-based scores in OS prediction. Furthermore, the predictive range was expanded by incorporating the NLR into the conventional stratification systems, including the AJCC stage and WHO classification systems. CONCLUSIONS As an independent prognostic factor, an elevated preoperative NLR is superior to the PLR with respect to predicting clinical outcomes in PNET patients undergoing potentially curative resection. The incorporation of the NLR into the existing conventional stratification systems improved the predictive accuracy.
本研究旨在评估术前中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）对接受潜在治愈性切除术的胰腺神经内分泌肿瘤（PNET）患者的预测和预后价值。
对 172 例 PNET 患者进行回顾性分析。采用 Kaplan-Meier 曲线和多变量 Cox 比例模型计算总生存期（OS）和无病生存期（DFS）。采用受试者工作特征（ROC）曲线分析比较 NLR 与其他炎症指标和传统分层系统的预测性能。
升高的 NLR 和 PLR 均与 AJCC 分期较高和分级较高相关。单因素分析显示，升高的 NLR 和 PLR 均与 OS 和 DFS 降低显著相关。多因素分析显示，术前 NLR 而非 PLR 是 OS（HR=4.471，95%CI 1.531-13.054，p=0.006）和 DFS（HR=2.531，95%CI 1.202-5.329，p=0.015）的独立危险因素。NLR 在 OS 预测中的判别能力优于其他炎症指标。此外，将 NLR 纳入 AJCC 分期和 WHO 分级等传统分层系统可扩大预测范围。
作为独立的预后因素，术前升高的 NLR 比 PLR 更能预测接受潜在治愈性切除术的 PNET 患者的临床结局。将 NLR 纳入现有的传统分层系统可提高预测准确性。
