Kazlow Esther, Rinawi Elias, Gerszman Eden, Mattar Samar, Essami Nabih, Nasir Mary, Abu Shtaya Aasem, Assaf Wisam, Haddad Riad, Mahamid Ahmad
Technion Israel Institute of Technology, Rappaport Faculty of Medicine, Haifa 3109601, Israel.
Department of Surgery, Carmel Medical Center, Michal Str. 7, Haifa 3436212, Israel.
J Clin Med. 2025 May 27;14(11):3762. doi: 10.3390/jcm14113762.
Pancreatic cancer has a high mortality rate worldwide. Most patients progress to advanced stages, often with metastasis, resulting in a low survival rate. Despite advancements in surgical and oncological treatments, early diagnosis and better risk stratification remain critical. : This retrospective cross-sectional study focused on analyzing data from patients undergoing pancreaticoduodenectomy for pancreatic adenocarcinoma, in order to determine whether the neutrophil-to-lymphocyte ratio (NLR) and other immune-inflammatory markers, such as the systemic immune-inflammation index (SII) and prognostic nutritional index (PNI), can predict postoperative complications and survival outcomes. : Analysis of 136 patients revealed that a higher NLR (≥2.5) was significantly associated with longer overall survival (39 months, IQR: 17-100 months; = 0.004), compared to lower NLR (<2.5; 18 months, IQR: 9-39 months). Higher SII (≥600) was also associated with significantly improved survival (34 months, IQR: 17-114 months; = 0.001) compared to lower SII (<600; 20 months, IQR: 9-45 months). No significant differences were observed in postoperative complications or other clinical outcomes between NLR groups, although a trend toward more complications in the higher NLR group was noted ( = 0.06). PNI showed no significant impact on survival (PNI < 38.8: 22 months, IQR: 14-60 months; PNI ≥ 38.8: 33 months, IQR: 14-115 months; = 0.1) or complications ( = 0.8). : Our study highlights the prognostic utility of NLR and SII in patients with adenocarcinoma of the head of the pancreas undergoing pancreaticoduodenectomy. Regarding complications, there were no significant differences across groups stratified by NLR, SII, or PNI, suggesting that while NLR and SII are valuable for predicting long-term oncological outcomes in patients undergoing pancreaticoduodenectomy for adenocarcinoma of the head of the pancreas, they may not be reliable indicators of immediate postoperative morbidity.
胰腺癌在全球范围内具有较高的死亡率。大多数患者会进展到晚期，常伴有转移，导致生存率较低。尽管手术和肿瘤治疗取得了进展，但早期诊断和更好的风险分层仍然至关重要。本项回顾性横断面研究聚焦于分析接受胰十二指肠切除术治疗胰腺腺癌患者的数据，以确定中性粒细胞与淋巴细胞比值（NLR）以及其他免疫炎症标志物，如全身免疫炎症指数（SII）和预后营养指数（PNI），是否能够预测术后并发症和生存结局。对136例患者的分析显示，与较低的NLR（<2.5；18个月，IQR：9 - 39个月）相比，较高的NLR（≥2.5）与更长的总生存期显著相关（39个月，IQR：17 - 100个月；P = 0.004）。与较低的SII（<600；20个月，IQR：9 - 45个月）相比，较高的SII（≥600）也与显著改善的生存期相关（34个月，IQR：17 - 114个月；P = 0.001）。在NLR组之间，术后并发症或其他临床结局未观察到显著差异，尽管在较高NLR组中存在并发症更多的趋势（P = 0.06）。PNI对生存（PNI < 38.8：22个月，IQR：14 - 60个月；PNI≥38.8：33个月，IQR：14 - 115个月；P = 0.1）或并发症（P = 0.8）均无显著影响。我们的研究强调了NLR和SII在接受胰十二指肠切除术的胰腺头部腺癌患者中的预后价值。关于并发症，按NLR、SII或PNI分层的各组之间无显著差异，这表明虽然NLR和SII对于预测接受胰腺头部腺癌胰十二指肠切除术患者的长期肿瘤学结局有价值，但它们可能不是术后近期发病率的可靠指标。
