Zhou Qian, Deng Guochao, Wang Zhikuan, Dai Guanghai
Department of Oncology, Medical School of Chinese People's Liberation Army (PLA), Beijing, China.
Department of Medical Oncology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
Front Surg. 2023 Jan 6;9:1002075. doi: 10.3389/fsurg.2022.1002075. eCollection 2022.
Lung immune prognostic index (LIPI), a combination of derived neutrophil-to-lymphocyte ratio (dNLR) and lactate dehydrogenase (LDH), is currently attracting considerable interest as a potential prognostic indicator in many malignancies. Our study aimed to investigate the prognostic value of preoperative LIPI in patients with pancreatic ductal adenocarcinoma (PDAC) undergoing radical resection.
We retrospectively reviewed PDAC patients treated with radical resection from February 2019 to April 2021 at Chinese People's Liberation Army (PLA) general hospital. Based on the cut-off value of dNLR and LDH identified by X-tile, patients were divided into LIPI good and LIPI intermediate/poor group. Kaplan-Meier curve and log-rank test were used to compare the recurrence-free survival (RFS) and overall survival (OS) of the two groups. Univariate and multivariate Cox regression was used to identify the independent prognostic value of LIPI. Subgroup analysis was performed to identify specific population benefited from radical resection.
A total of 205 patients were included and the median RFS and OS was 10.8 and 24.3 months, respectively. Preoperative LIPI intermediate/poor was related to worse RFS and OS ( < 0.05). Preoperative LIPI intermediate/poor, vascular invasion and no adjuvant chemotherapy were indicators of poor OS. Patients with LIPI intermediate/poor had worse OS especially among females and those with adjuvant chemotherapy ( < 0.05). Adjuvant chemotherapy related to better RFS and OS in patients with LIPI good ( < 0.05).
Preoperative LIPI intermediate/poor can be an indicator of poor prognosis in patients with PDAC undergoing radical resection. LIPI good could be an effective marker of benefit from adjuvant chemotherapy. Larger studies are warranted for further validation.
肺免疫预后指数（LIPI），即衍生中性粒细胞与淋巴细胞比值（dNLR）和乳酸脱氢酶（LDH）的组合，目前作为许多恶性肿瘤潜在的预后指标备受关注。我们的研究旨在探讨术前LIPI对接受根治性切除的胰腺导管腺癌（PDAC）患者的预后价值。
我们回顾性分析了2019年2月至2021年4月在中国人民解放军总医院接受根治性切除的PDAC患者。根据X-tile确定的dNLR和LDH临界值，将患者分为LIPI良好组和LIPI中等/不良组。采用Kaplan-Meier曲线和对数秩检验比较两组的无复发生存期（RFS）和总生存期（OS）。单因素和多因素Cox回归用于确定LIPI的独立预后价值。进行亚组分析以确定从根治性切除中获益的特定人群。
共纳入205例患者，中位RFS和OS分别为10.8个月和24.3个月。术前LIPI中等/不良与较差的RFS和OS相关（<0.05）。术前LIPI中等/不良、血管侵犯和未接受辅助化疗是OS不良的指标。LIPI中等/不良的患者OS较差，尤其是女性和接受辅助化疗的患者（<0.05）。辅助化疗与LIPI良好的患者更好的RFS和OS相关（<0.05）。
术前LIPI中等/不良可作为接受根治性切除的PDAC患者预后不良的指标。LIPI良好可能是从辅助化疗中获益的有效标志物。需要更大规模的研究进行进一步验证。
