Validation of the pretreatment neutrophil-lymphocyte ratio as a predictor of overall survival in a cohort of patients with pancreatic ductal adenocarcinoma

Pancreas. 2015 Apr;44(3):471-7. doi: 10.1097/MPA.0000000000000271.

Abstract

Objectives: The circulating neutrophil-lymphocyte ratio (NLR) has been shown to be a prognostic factor for a variety of tumors. In this study, we evaluated the prognostic significance of NLR in a large cohort of Chinese patients with pancreatic ductal adenocarcinomas (PDACs).

Methods: A total of 381 patients with PDAC who underwent potentially curative surgery were recruited from 2 centers in Shanghai, China, between January 2004 and September 2011. Analysis of overall survival (OS) was performed using the Kaplan-Meier and log-rank tests and the Cox proportional hazards regression model.

Results: The most optimal cutoff of NLR was NLR 2.0 or greater, and the NLR was divided into 2 groups: high (≥ 2.0) and low (< 2.0). The high NLR (≥ 2.0) was associated with advanced UICC (Union for International Cancer Control) stages, p T stage, lymphoid node invasion, and poorer tumor differentiation. Multivariate analysis identified increased NLR as an independent prognostic factor for OS (hazard ratio = 1.51; 95 % confidence interval, 1.15-1.99; P = 0.003). Furthermore, neutrophil counts rather than lymphocyte counts were associated with OS of PDAC.

Conclusions: The pretreatment NLR is a simple and useful potential biomarker for OS in patients with PDAC after curative resection.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Pancreatic Ductal / blood*
  • Carcinoma, Pancreatic Ductal / mortality
  • Carcinoma, Pancreatic Ductal / pathology
  • Carcinoma, Pancreatic Ductal / therapy
  • China
  • Databases, Factual
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphocyte Count*
  • Lymphocytes*
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Neutrophils*
  • Pancreatic Neoplasms / blood*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology
  • Pancreatic Neoplasms / therapy
  • Predictive Value of Tests
  • Proportional Hazards Models
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Young Adult