Department of Internal Medicine II, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Department of Surgery, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Ann Med. 2024 Dec;56(1):2398725. doi: 10.1080/07853890.2024.2398725. Epub 2024 Sep 2.
Although systemic chemotherapy for pancreatic ductal adenocarcinoma (PDAC) has made progress, ensuring long-term survival remains difficult. There are several reports on the usefulness of neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of PDAC, but few reports in systemic chemotherapy. We hereby investigated the usefulness of NLR in systemic chemotherapy for PDAC.
A retrospective study was conducted on patients with advanced PDAC treated with first-line systemic chemotherapy. Cox regression hazards models were performed to analyze the association between baseline patient characteristics and the initial treatment response, and overall survival (OS).
A total of 60 patients with PDAC were enrolled. At baseline, there were significant differences in NLR and carbohydrate antigen 19-9 (CA19-9), as well as the selection rate of combination chemotherapy, between patients with partial response or stable disease and those with progressive disease. Univariate and multivariate analysis showed that NLR < 3.10, combination chemotherapy, and CA19-9 < 1011 U/mL were significant and independent predictive factors of the initial treatment response. Meanwhile, NLR < 3.10 and combination chemotherapy were independently associated with longer OS. Moreover, OS was significantly prolonged in patients with NLR < 3.10, regardless of whether combination chemotherapy or monotherapy. Patients with NLR < 3.10 at baseline had a significantly higher conversion rate to third-line chemotherapy and a longer duration of total chemotherapy.
This study suggests that NLR may be a useful marker for predicting the initial treatment response to first-line chemotherapy and the prognosis for patients with advanced PDAC.
尽管针对胰腺导管腺癌（PDAC）的全身化疗已经取得了进展，但确保长期生存仍然困难。有几项关于中性粒细胞与淋巴细胞比值（NLR）在预测 PDAC 预后方面的有用性的报告，但在全身化疗方面的报告较少。我们在此研究 NLR 在 PDAC 全身化疗中的作用。
对接受一线全身化疗治疗的晚期 PDAC 患者进行回顾性研究。采用 Cox 回归风险模型分析基线患者特征与初始治疗反应和总生存期（OS）之间的关系。
共纳入 60 例 PDAC 患者。基线时，部分缓解或疾病稳定患者与疾病进展患者在 NLR 和碳水化合物抗原 19-9（CA19-9）以及联合化疗的选择率方面存在显著差异。单因素和多因素分析表明，NLR<3.10、联合化疗和 CA19-9<1011 U/mL 是初始治疗反应的显著独立预测因素。同时，NLR<3.10 和联合化疗与更长的 OS 独立相关。此外，无论联合化疗还是单药治疗，NLR<3.10 的患者 OS 均显著延长。基线时 NLR<3.10 的患者三线化疗转化率和总化疗持续时间明显延长。
本研究表明，NLR 可能是预测一线化疗初始治疗反应和晚期 PDAC 患者预后的有用标志物。
