Department of Surgery, Nara Medical University, Japan.
Department of Surgery, Nara Medical University, Japan.
Pancreatology. 2019 Jul;19(5):722-728. doi: 10.1016/j.pan.2019.05.461. Epub 2019 May 23.
Although the prognosis of recurrent pancreatic cancer (RPC) is improving with the appearance of new anticancer drugs, prognostic indicators for RPC are still poorly understood. The aim of this study was to evaluate significance of the inflammation-based prognostic score, including modified Glasgow Prognostic Score (mGPS), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and Prognostic Nutritional Index (PNI), in patients with RPC.
This study reviewed 263 patients of pancreatic ductal adenocarcinoma at our institution between 2006 and 2015. A receiver operating characteristics curve analysis was performed to determine the cut-off values. The prognostic significance of the inflammation-based prognostic scores were evaluated by a multivariate analysis.
172 patients (65.4%) who had recurrence was included in this study. The optimal PNI for predicting 1-year survival after recurrence was 40 with higher area under receiver operating characteristics curve value (0.704) in comparison with other inflammation-based prognostic scores. A univariate and multivariate analysis revealed that liver metastasis (P < 0.001) and PNI < 40 (P < 0.001) were independently associated with the survival time after recurrence. When each of the two predictors was counted as one point and the points were calculated for all cases, a good stratified survival curve was obtained, showing the shorter survival in the higher points: median survival times of 2, 1, and 0 points were 4.3, 11.1, and 21.2 months, respectively (P < 0.001).
Inflammation-based prognostic scores, especially PNI is useful clinical biomarker for predicting the survival time after recurrence in patients with pancreatic adenocarcinoma.
尽管新抗癌药物的出现改善了复发性胰腺癌（RPC）的预后，但RPC 的预后指标仍知之甚少。本研究旨在评估包括改良格拉斯哥预后评分（mGPS）、中性粒细胞与淋巴细胞比值（NLR）、血小板与淋巴细胞比值（PLR）、淋巴细胞与单核细胞比值（LMR）和预后营养指数（PNI）在内的炎症相关预后评分在 RPC 患者中的意义。
本研究回顾了 2006 年至 2015 年期间在我院就诊的 263 例胰腺导管腺癌患者。通过接受者操作特征曲线分析确定截断值。通过多变量分析评估炎症相关预后评分的预后意义。
本研究纳入了 172 例（65.4%）有复发的患者。预测复发后 1 年生存的最佳 PNI 为 40，其接受者操作特征曲线下面积值（0.704）高于其他炎症相关预后评分。单因素和多因素分析表明，肝转移（P<0.001）和 PNI<40（P<0.001）与复发后生存时间独立相关。当将两个预测因子各计为 1 分并对所有病例进行计分，得到了一个良好的分层生存曲线，表明得分越高生存时间越短：2、1 和 0 分的中位生存时间分别为 4.3、11.1 和 21.2 个月（P<0.001）。
炎症相关预后评分，尤其是 PNI，是预测胰腺腺癌患者复发后生存时间的有用临床生物标志物。
