| Background: Pancreatic cancer has a high degree of concealment and malignancy.There is no biomarker and survival model which can accurately predict the prognosis of the pantients in clinic and that has limited the development of precise treatment for pancreatic cancer.Object: To explore the value of various blood test indexes and peripheral immune cell test in predicting the prognosis of patients with advanced pancreatic cancer,and to establish a survival model for patients with advanced pancreatic ductal carcinoma.Method: All the advanced pancreatic cancer patients who were admitted were hospitalized in the Shanghai General Hospital from 2009 to 2017 without anti-tumor treatment,and they all had complete clinical data.The results of blood test and peripheral immune cell test were collected before treatment,the overall survival was followed up,the correlation between indexes and prognosis was analyzed,and the survival model was established.Results: The levels of serum lactate dehydrogenase,carbohydrate antigen 19-9,C-reaction protein and albumin in patients with advanced pancreatic cancer before anti-tumor treatment were independent risk factors of prognosis,which were related to the overall survival of patients.Patients with elevated serum levels of lactate dehydrogenase,carbohydrate antigen 19-9,C-reaction protein and reduced serum level of albumin has shorter overall survival.The survival model of the combined score based on the four blood test indicators above was related to the patients' overall survival and the higher the score,the shorter the oerall survival.In addition,peripheral CD3+CD4+CD8-T helper/inducible lymphocyte levels,CD4+/CD8+ lymphocyte ratio and CD3-CD(16+56)+ natural killer cell(NK)levels before anti-tumor treatment were independent risk factors of prognosis in patients and they were related to patients' overall survival.The patients with lower level of CD3+CD4+CD8-T helper/inducible lymphocytes and CD4+/CD8+ lymphocyte ratio and higher level of CD3-CD(16+56)+ Natural killer(NK)cells had shorter overall survival.The survival model of the combined score based on based on the above three peripheral immune cell tests was related to the patients' overall survival and the higher the score,the shorter the overall survival.Conclusion: The levels of serum lactate dehydrogenase,carbohydrate antigen 19-9,C-reaction protein and albumin before anti-tumor treatment and the survival model based on the above four blood test results have clinical value in the prognosis of patients with advanced pancreatic cancer.In addition,the levels of peripheral blood CD3+CD4+CD8-T helper/inducible lymphocytes,CD4+/CD8+ lymphocyte ratio and level of CD3-CD(16+56)+ natural killer cells(NK)before anti-tumor treatment and the survival model based on the above three peripheral immune cell tests have clinical value in the prognosis of patients with advanced pancreatic cancer. |
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