Panni Roheena Z, Lopez-Aguiar Alexandra G, Liu Jingxia, Poultsides George A, Rocha Flavio G, Hawkins William G, Strasberg Steven M, Trikalinos Nikolaos A, Maithel Shishir, Fields Ryan C
Division of HPB and GI Surgery, Washington University School of Medicine, St. Louis, Missouri.
Division of Surgical Oncology, Department of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia.
J Surg Oncol. 2019 Sep;120(4):632-638. doi: 10.1002/jso.25629. Epub 2019 Jul 24.
Preoperative systemic inflammatory response plays a crucial role in tumorigenesis, progression, and prognosis; and neutrophil, monocyte, and lymphocyte counts serve as important biomarkers. An altered monocyte-to-lymphocyte ratio (MLR) and neutrophil-to-lymphocyte ratio (NLR) has been reported to be associated with a favorable prognosis for certain hematologic malignancies and breast cancer. The aim of this study was to investigate the prognostic significance of MLR, NLR in patients with resectable PNETs.
Patients undergoing surgery for PNETs between 2000 and 2016 were identified using a large, multi-center database. NLR and MLR were calculated and Contal and O'Quigley analysis was used to determine the optimal cutoff value.
A total of 620 patients were included in the analytic cohort. The prognostic implications of blood count parameters were evaluated in both univariate and multivariate analysis. The univariate analysis revealed that low MLR and NLR is associated with significantly improved overall survival (OS; P < .01) and recurrence-free survival (RFS; P < .01). On multivariate analysis, in addition to tumor size and grade, NLR was an independent predictor of improved OS and RFS.
In addition to established tumor-specific factors, preoperative NLR levels can serve as a valuable biomarker that can be used as a predictor of OS and RFS after resection of PNETs.
术前全身炎症反应在肿瘤发生、发展及预后中起关键作用；中性粒细胞、单核细胞及淋巴细胞计数是重要的生物标志物。据报道，单核细胞与淋巴细胞比值（MLR）及中性粒细胞与淋巴细胞比值（NLR）的改变与某些血液系统恶性肿瘤及乳腺癌的良好预后相关。本研究旨在探讨MLR、NLR在可切除的胰腺神经内分泌肿瘤（PNETs）患者中的预后意义。
利用一个大型多中心数据库识别2000年至2016年间接受PNETs手术的患者。计算NLR和MLR，并采用Contal和O'Quigley分析确定最佳临界值。
分析队列共纳入620例患者。在单因素和多因素分析中评估血细胞计数参数的预后意义。单因素分析显示，低MLR和NLR与显著改善的总生存期（OS；P < .01）和无复发生存期（RFS；P < .01）相关。多因素分析中，除肿瘤大小和分级外，NLR是OS和RFS改善的独立预测因素。
除了已确定的肿瘤特异性因素外，术前NLR水平可作为一种有价值的生物标志物，用于预测PNETs切除术后的OS和RFS。
