Asama Hiroyuki, Suzuki Rei, Takagi Tadayuki, Sugimoto Mitsuru, Konno Naoki, Watanabe Ko, Nakamura Jun, Kikuchi Hitomi, Takasumi Mika, Sato Yuki, Irie Hiroki, Hikichi Takuto, Ohira Hiromasa
Department of Gastroenterology, Fukushima Medical University, School of Medicine, Fukushima 960-1247, Japan.
Department of Endoscopy, Fukushima Medical University, School of Medicine, Fukushima 960-1247, Japan.
Mol Clin Oncol. 2018 Oct;9(4):408-414. doi: 10.3892/mco.2018.1696. Epub 2018 Aug 10.
Predicting the prognosis of unresectable pancreatic ductal adenocarcinoma (PDAC) is useful in determining the appropriate management strategy. The present study aimed to investigate the association between PDAC prognosis and inflammation-based markers, such as the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, prognostic nutritional index, modified Glasgow prognostic score (mGPS) and controlling nutritional status score. A total of 72 patients with unresectable PDAC who received chemotherapy were included. Inflammation-based markers were measured prior to treatment. The median progression-free survival (PFS) and overall survival (OS) were 117 days (range, 10-781 days) and 244 days (range 43-781 days), respectively. The cut-off value of continuous variables that predicted the median OS (244 days) was calcualted. Univariate analysis of PFS showed that disease stage, first-line chemotherapy regimen, carcinoembryonic antigen (CEA), NLR, platelet-to-lymphocyte ratio (PLR), mGPS and controlling nutritional status (CONUT) scores were associated with PFS. Among them, stage, first-line chemotherapy regimen, CEA, NLR and mGPS were independent prognostic factors for PFS in multivariate analysis. Univariate analysis of OS showed that stage, first-line chemotherapy regimen, CA19-9, NLR, PLR, prognostic nutritional index (PNI), mGPS and CONUT score were associated wtih OS. Among them, first-line chemotherapy and mGPS were independent prognostic factors for OS according to multivariate analysis. Univariate and multivariate analyses revealed that a NLR ≥4.0 and mGPS 2 were independent prognostic factors for PFS. For OS, mGPS 2 was an independent prognostic factor. In conclusion, mGPS was the most useful marker in predicting the prognosis of patients with unresectable PDAC who received chemotherapy.
预测不可切除胰腺导管腺癌(PDAC)的预后对于确定合适的治疗策略很有帮助。本研究旨在探讨PDAC预后与基于炎症的标志物之间的关联,如中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值、预后营养指数、改良格拉斯哥预后评分(mGPS)和控制营养状况评分。总共纳入了72例接受化疗的不可切除PDAC患者。在治疗前测量基于炎症的标志物。中位无进展生存期(PFS)和总生存期(OS)分别为117天(范围10 - 781天)和244天(范围43 - 781天)。计算出预测中位OS(244天)的连续变量的临界值。PFS的单因素分析表明,疾病分期、一线化疗方案、癌胚抗原(CEA)、NLR、血小板与淋巴细胞比值(PLR)、mGPS和控制营养状况(CONUT)评分与PFS相关。其中,分期、一线化疗方案、CEA、NLR和mGPS是多因素分析中PFS的独立预后因素。OS的单因素分析表明,分期、一线化疗方案、CA19 - 9、NLR、PLR、预后营养指数(PNI)、mGPS和CONUT评分与OS相关。其中,根据多因素分析,一线化疗和mGPS是OS的独立预后因素。单因素和多因素分析均显示,NLR≥4.0和mGPS 2是PFS的独立预后因素。对于OS,mGPS 2是独立预后因素。总之,mGPS是预测接受化疗的不可切除PDAC患者预后最有用的标志物。