Department of General Surgery, Zhongshan Hospital Fudan University, Ward 9, Building No.1, 180 Fenglin Road, Shanghai, China.
Int J Clin Oncol. 2021 Jan;26(1):135-144. doi: 10.1007/s10147-020-01782-y. Epub 2020 Sep 21.
Inflammatory factors and fasting blood glucose were verified to be associated with the prognosis of pancreatic ductal adenocarcinoma. The goal of this study is to confirm the prognostic role of preoperative blood glucose to lymphocyte ratio for patients with resected pancreatic ductal adenocarcinoma.
A total of 259 pancreatic ductal adenocarcinoma patients were enrolled and randomly divided into training cohort and validation cohort. The training cohort was used to generate an optimal cutoff value and the validation cohort was used to further validate the model.
A total of 259 patients were incorporated in this study and randomly divided into the training cohort (n = 130, 1/2 of 259) and the validation cohort (129, 1/2 of 259). The optimal cutoff value of glucose to lymphocyte ratio was calculated to be 3.47 for overall survival. Cox regression analysis found that preoperative blood glucose to lymphocyte ratio was independent risk factor (p = 0.040) for overall survival. Prognostic values of glucose to lymphocyte ratio on overall survival were observed in younger male patients with pancreatic body and tail cancer, American Joint Committee on Cancer 8th N1 stage, without microvascular and peripancreatic fat invasion, and Carbohydrate antigen 19-9 higher than 200 U/ml. A prognostic prediction model of overall survival was designed and presented in nomogram.
Preoperative blood glucose to lymphocyte ratio is an independent biomarker to predict the overall survival for pancreatic ductal adenocarcinoma patients who underwent curative resection.
炎症因子和空腹血糖被证实与胰腺导管腺癌的预后相关。本研究旨在证实术前血糖与淋巴细胞比值对接受根治性切除术的胰腺导管腺癌患者的预后作用。
共纳入 259 例胰腺导管腺癌患者，并随机分为训练队列和验证队列。训练队列用于生成最佳截断值，验证队列用于进一步验证模型。
本研究共纳入 259 例患者，并随机分为训练队列（n=130，259 的 1/2）和验证队列（n=129，259 的 1/2）。计算出的最佳截断值为 3.47，用于预测总生存期。Cox 回归分析发现，术前血糖与淋巴细胞比值是总生存期的独立危险因素（p=0.040）。在年龄较小的男性胰腺体尾部癌患者、美国癌症联合委员会第 8 版 N1 期、无微血管和胰腺周围脂肪侵犯以及 CA19-9 高于 200 U/ml 的患者中，观察到血糖与淋巴细胞比值对总生存期的预后价值。设计并在列线图中呈现了一个用于总生存期预测的预后预测模型。
术前血糖与淋巴细胞比值是接受根治性切除术的胰腺导管腺癌患者总生存期的独立生物标志物。
