Cavdar Vahit Can, Gokmen Yalcin, Aric Mert, Altunkaya Tugba, Erdem Cennet Gizem, Gulturk Ilkay, Afsar Cigdem Usul
Department of Internal Medicine, Istanbul Training and Research Hospital, University of Health Sciences, Istanbul 34098, Turkey.
Department of Internal Medicine, Beylikduzu State Hospital, Istanbul 34500, Turkey.
Diagnostics (Basel). 2025 Jul 9;15(14):1740. doi: 10.3390/diagnostics15141740.
Pancreatic cancer (PC) is an aggressive malignancy with a poor prognosis, frequently diagnosed at a metastatic stage. The identification of accessible, cost-effective prognostic biomarkers is critical for optimizing treatment strategies. The Endothelial Activation and Stress Index (EASIX), calculated using lactate dehydrogenase (LDH), creatinine, and platelet count, reflects endothelial dysfunction and has shown prognostic value in hematological cancers. However, its utility in metastatic PC remains unexplored. This study is the first to evaluate the prognostic significance of the EASIX in patients with metastatic PC receiving first-line FOLFIRINOX chemotherapy. This retrospective cohort study analyzed 204 patients diagnosed with metastatic pancreatic adenocarcinoma at Istanbul Training and Research Hospital between 2020 and 2025. All patients received FOLFIRINOX as first-line therapy. EASIX was calculated as LDH (U/L) × creatinine (mg/dL)/platelet count (10/L). A cut-off value of 1.33 was used to stratify patients into low and high EASIX groups. Overall survival (OS) was assessed using Kaplan-Meier analysis and compared with the log-rank test. The mean patient age was 63.0 ± 9.4 years; 61.8% were male. There were no significant differences in baseline characteristics between groups. Patients with EASIX ≥ 1.33 had significantly lower platelet counts and higher LDH and creatinine levels. Median OS was 14 months for EASIX < 1.33 and 8 months for EASIX ≥ 1.33 ( < 0.001). EASIX is a simple, inexpensive prognostic marker associated with overall survival in metastatic PC. Its integration into clinical practice may facilitate early risk stratification. Further prospective studies are needed to confirm its prognostic utility.
胰腺癌（PC）是一种侵袭性恶性肿瘤，预后较差，常在转移阶段被诊断出来。识别可获取的、具有成本效益的预后生物标志物对于优化治疗策略至关重要。内皮激活与应激指数（EASIX）由乳酸脱氢酶（LDH）、肌酐和血小板计数计算得出，反映内皮功能障碍，已在血液系统癌症中显示出预后价值。然而，其在转移性胰腺癌中的效用仍未得到探索。本研究首次评估了EASIX在接受一线FOLFIRINOX化疗的转移性胰腺癌患者中的预后意义。这项回顾性队列研究分析了2020年至2025年间在伊斯坦布尔培训与研究医院被诊断为转移性胰腺腺癌的204例患者。所有患者均接受FOLFIRINOX作为一线治疗。EASIX的计算方法为LDH（U/L）×肌酐（mg/dL）/血小板计数（10/L）。采用1.33的临界值将患者分为EASIX低分组和高分组。使用Kaplan-Meier分析评估总生存期（OS），并通过对数秩检验进行比较。患者的平均年龄为63.0±9.4岁；61.8%为男性。两组间基线特征无显著差异。EASIX≥1.33的患者血小板计数显著更低，LDH和肌酐水平更高。EASIX<1.33组的中位OS为14个月，EASIX≥1.33组为8个月（<0.001）。EASIX是一种简单、廉价的预后标志物，与转移性胰腺癌的总生存期相关。将其纳入临床实践可能有助于早期风险分层。需要进一步的前瞻性研究来证实其预后效用。
