Cheng Hao, Lu Dingyu, Yin Chuou, Fang Yeying
Department of Oncology, People's Hospital of Deyang City Deyang 618000, Sichuan, China.
Department of Radiation Oncology, The First Affiliated Hospital of Guangxi Medical University Nanning 530021, Guangxi, China.
Am J Transl Res. 2024 Nov 15;16(11):7165-7175. doi: 10.62347/ZOHP7650. eCollection 2024.
To investigate the expression and prognostic value of neutrophil-to-lymphocyte ratio (NLR) and fibrinogen-to-albumin ratio (FAR) in patients with locally advanced or metastatic pancreatic cancer (PC).
This retrospective study included 118 cases diagnosed with metastatic or locally advanced PC who received systemic chemotherapy at People's Hospital of Deyang City from January 2018 to February 2021. Data and blood indicators were collected from patients, and the platelet-to-lymphocyte ratio (PLR), NLR, and FAR were calculated. Receiver operating characteristic (ROC) curves were used to determine optimal cutoff values. Kaplan-Meier survival curves were plotted, and the Log-rank test was employed for intergroup survival analysis. Prognostic factors affecting the prognosis of PC patients were identified using multiple Cox regression analysis.
The optimal cutoff values of FAR and NLR were 0.1 and 3.28 respectively, with areas under the curve (AUC) of 0.776 and 0.804, respectively. Significant differences were observed between the low FAR and high FAR groups in terms of tumor invasion into large blood vessels, distant metastasis, and pre-treatment NLR (all P < 0.05). Similarly, significant differences were observed between the low NLR and high NLR groups in terms of distant metastasis, pre-treatment FAR, and pre-treatment PLR (all P < 0.05). At the end of the follow-up, 65 patients died and 53 survived. The 24-month survival rate was 97.62% in the high FAR group, significantly higher than 31.58% in the low FAR group (P < 0.001). The 24-month survival rate for the high NLR group was 91.30%, also significantly higher than 31.94% in the low NLR group (P < 0.001). In the Cox regression model, both high FAR and high NLR were identified as independent risk factors for poor prognosis in PC patients (all P < 0.05). The AUC for FAR combined with NLR in predicting the prognosis of PC patients was 0.946 (95% CI: 0.905-0.986), with a specificity of 92.30% and a sensitivity of 92.40%.
Both FAR and NLR are correlated with prognosis in patients suffering from locally advanced or metastatic PC, and their combined detection may precisely predict prognosis in PC patients undergoing systemic chemotherapy.
探讨中性粒细胞与淋巴细胞比值（NLR）及纤维蛋白原与白蛋白比值（FAR）在局部晚期或转移性胰腺癌（PC）患者中的表达及预后价值。
本回顾性研究纳入了2018年1月至2021年2月在德阳市人民医院接受全身化疗的118例诊断为转移性或局部晚期PC的患者。收集患者的数据和血液指标，并计算血小板与淋巴细胞比值（PLR）、NLR和FAR。采用受试者工作特征（ROC）曲线确定最佳临界值。绘制Kaplan-Meier生存曲线，并采用Log-rank检验进行组间生存分析。使用多因素Cox回归分析确定影响PC患者预后的预后因素。
FAR和NLR的最佳临界值分别为0.1和3.28，曲线下面积（AUC）分别为0.776和0.804。低FAR组和高FAR组在肿瘤侵犯大血管、远处转移和治疗前NLR方面存在显著差异（均P<0.05）。同样，低NLR组和高NLR组在远处转移、治疗前FAR和治疗前PLR方面也存在显著差异（均P<0.05）。随访结束时，65例患者死亡，53例存活。高FAR组的24个月生存率为97.62%，显著高于低FAR组的31.58%（P<0.001）。高NLR组的24个月生存率为91.30%，也显著高于低NLR组的31.94%（P<0.001）。在Cox回归模型中，高FAR和高NLR均被确定为PC患者预后不良的独立危险因素（均P<0.05）。FAR联合NLR预测PC患者预后的AUC为0.946（95%CI：0.905-0.986），特异性为92.30%，敏感性为92.40%。
FAR和NLR均与局部晚期或转移性PC患者的预后相关，联合检测它们可能准确预测接受全身化疗的PC患者的预后。
