| Purpose: To explore the effect of systemic inflammation index neutrophil to lymphocyte ratio NLR on the prognostic survival time of patients with pancreatic cancer and the relationship between NLR and TCM syndromes in patients with pancreatic cancer,and speculate the mechanism of action of heat-clearing and detoxifying drugs in the treatment of pancreatic cancer.Material and method:A total of 71 cases of pancreatic cancer patients who died of pancreatic cancer who were hospitalized between September 2015 and September 2020 were collected from the Inpatient Department of the Oncology Department of the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine.Statistics of the blood routine at the time of admission for the first time,including neutrophils,lymphocytes,and the ratio of neutrophils to lymphocytes(NLR),and the median of neutrophils,lymphocytes,and MLR as cut-off values.Divide equally into high and low groups.According to the patient’s four consultations of traditional Chinese medicine,including the main complaint,symptoms,signs,tongue coating and pulse condition,the dialectical analysis of traditional Chinese medicine is carried out.The specific survival days from the first admission to death of 71patients with pancreatic cancer were reviewed,and the effects of various factors on the prognosis and survival were statistically summarized and analyzed.Results:1.The overall median survival time of 71 pancreatic cancer patients was 45 days,and the average survival time was 100.59 days.2.The rank correlation test showed that neutrophils,NLR and the prognostic survival time of pancreatic cancer patients were all significantly correlated(all P values <0.01).There is a general correlation between lymphocytes and the prognostic survival time of patients with pancreatic cancer(P<0.05).3.The prognostic survival time of neutrophils,lymphocytes,and NLR groups are significantly different.The median survival time of 36 patients in the high neutrophil group(≥5.53)was 23 days and the average survival time was 37 days.The median survival time of35 patients in the low neutrophil group(<5.53)was 90 days and the average survival time was166 days(P <0.01).The median survival time of 36 patients in the high lymphocyte group(≥0.88)was 46 days and the average survival time was 145.28 days.The median survival time of 35 patients in the low lymphocyte group(<0.88)was 35 days and the average survival time was 54.63 days(P<0.01).The median survival time of 36 patients in the high NLR group(≥6.96)was 22 days and the average survival time was 34.64 days.The median survival time of 35 patients in the low NLR group(<6.96)was 93 days and the average survival time was 168.43 days(P<0.01).4.COX univariate analysis showed that neutrophil count and NLR are the prognostic risk factors that affect the death of pancreatic cancer patients(P<0.01),and lymphocyte count may not be the prognostic risk factor that affects the death of pancreatic cancer patients(P>0.05).COX multivariate regression analysis showed that neutrophils and NLR were independent risk factors affecting the death of pancreatic cancer patients(P<0.01).The risk of death in the high NLR group was 2.415 times that of the low NLR group(RR=2.415).5.71 cases of pancreatic cancer took damp-heat toxin accumulation syndrome as the main syndrome type.In the high NLR group,most of the syndrome types are mainly damp-heat and poison-accumulation syndrome,with high mortality risk and poor prognosis.In the low NLR group,most of the syndrome types are mainly liver-stagnation and spleen-deficiency syndrome,with longer survival time and better prognosis.Conclusion:1.The inflammatory index NLR is a risk factor that affects the prognosis and survival of patients with pancreatic cancer.Active adjustment and intervention of inflammatory conditions in the body may have a certain effect on the prognosis of patients.2.NLR may be related to the TCM syndromes of pancreatic cancer.Chinese herbal medicines contain a variety of anti-inflammatory ingredients,such as heat-clearing and detoxifying drugs,dandelion and barbata,which may provide new help in the treatment of pancreatic tumors with TCM.. |
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