Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-Ku, Yokohama, 241-8515, Japan.
Department of Surgery, Yokohama City University, 3-9 Fukuura, Kanazawa-Ku, Yokohama, 236-0004, Japan.
Langenbecks Arch Surg. 2024 Oct 21;409(1):317. doi: 10.1007/s00423-024-03512-8.
The C-reactive protein-albumin-lymphocyte (CALLY) index, which simultaneously evaluates the nutritional, immunological, and inflammatory statuses, is a new prognostic biomarker in patients with various cancers; however, no study has reported the clinical significance of the CALLY index in patients with pancreatic cancer. This study aimed to investigate whether the preoperative CALLY index is a prognostic biomarker in patients undergoing surgical resection of pancreatic cancer.
We retrospectively enrolled 461 patients with pancreatic cancer who underwent surgical resection between January 2013 and December 2022. The overall survival (OS) and relapse-free survival (RFS) rates were calculated using the Kaplan-Meier method. Univariate and multivariate analyses were performed using Cox proportional hazards regression models.
The optimal cut-off value for the preoperative CALLY index was 1.9. In the low CALLY group, patients were older (p = 0.012), more patients underwent pancreaticoduodenectomy (p = 0.002), the median tumor size was larger (p < 0.001), more patients had pathologically confirmed metastatic lymph nodes (p = 0.015) and worse pathological stage (p = 0.015), and fewer patients received adjuvant chemotherapy (p = 0.003). A low CALLY index was associated with decreased OS (22.1 vs. 37.9 months) and RFS (12.4 vs. 16.4 months). Univariate and multivariate analyses showed that the preoperative CALLY index was an independent prognostic factor for OS (p < 0.001) and RFS (p = 0.045).
The preoperative CALLY index is a prognostic biomarker for both OS and RFS in patients undergoing surgery for pancreatic cancer.
C 反应蛋白-白蛋白-淋巴细胞（CALLY）指数同时评估了营养、免疫和炎症状态，是各种癌症患者的一种新的预后生物标志物；然而，尚无研究报道 CALLY 指数在胰腺癌患者中的临床意义。本研究旨在探讨术前 CALLY 指数是否是接受胰腺癌手术切除患者的预后生物标志物。
我们回顾性纳入了 2013 年 1 月至 2022 年 12 月期间接受手术切除的 461 例胰腺癌患者。使用 Kaplan-Meier 方法计算总生存期（OS）和无复发生存期（RFS）。使用 Cox 比例风险回归模型进行单因素和多因素分析。
术前 CALLY 指数的最佳截断值为 1.9。在低 CALLY 组中，患者年龄更大（p=0.012），更多患者接受胰十二指肠切除术（p=0.002），肿瘤中位直径更大（p<0.001），更多患者有病理证实的转移性淋巴结（p=0.015）和较差的病理分期（p=0.015），且更少患者接受辅助化疗（p=0.003）。低 CALLY 指数与降低的 OS（22.1 与 37.9 个月）和 RFS（12.4 与 16.4 个月）相关。单因素和多因素分析显示，术前 CALLY 指数是 OS（p<0.001）和 RFS（p=0.045）的独立预后因素。
术前 CALLY 指数是接受胰腺癌手术患者 OS 和 RFS 的预后生物标志物。
