Prognosis Value Of Neutrophil To Lymphocyte Ratio(NLR) For Pancreatic Cancer Patients After Radical Resection

Background:Among the major solid tumors,pancreatic cancer is shunned by its high degree of malignancy,limited treatment,and poor prognosis.Like other solid tumors,the main treatments for pancreatic cancer are chemotherapy,radiotherapy,and surgical treatment.Chemotherapy,radiotherapy,or combination of chemotherapy,radiotherapy,or both are recommended for patients with peripheral invasion or distant metastasis that cannot be resected or limbic.However,compared with resectable patients,the survival rate is much lower[1].Therefore,although only about 20%of the patients have a chance of surgical treatment,we still regard surgical treatment as the first choice of treatment for these patients who can be excised and excised from the margin.Case[2].In this way,it is necessary to look for prognostic factors for postoperative patients with pancreatic cancer.In recent years,it is generally believed that the prognosis of tumor patients is influenced not only by the characteristics of the tumor itself,but also by host-related factors,such as gender,age,general condition,hematological parameters related to inflammation,and so on.This view has aroused widespread concern and related reports,and the study of neutrophil count to lymphocyte count ratio(neutrophil-to-lymphocyte ratio,NLR)has become the focus of research[2-3].At present,there are many reports about the value of NLR in evaluating the prognosis of lung cancer,liver cancer,esophageal cancer,ovarian cancer and so on.NLR is considered as a good indicator to evaluate the prognosis of these tumors[2-3].However,there are few studies on the prognostic value of NLR in pancreatic cancer.Objective:The aim of the study was to investigate the clinical value of peripheral blood neutrophil to lymphocyte ratio(NLR)in the prognosis assessment of patients after radical resection of pancreatic adenocarcinoma.Methods:1.From June 1,2012 to June 30,2015,the detailed data of 256 patients with pancreatic cancer who underwent radical resection of pancreatic cancer in our hepatobiliary and pancreatic surgery were retrospectively analyzed,including general data,routine pathological results,and postoperative follow-up results.According to the criteria of inclusion and exclusion,77 patients with pancreatic cancer were divided into two groups according to NLR ratio:high NLR group(38 patients)and low NLR group(39 patients).The differences of postoperative survival time and its influencing factors between the two groups were compared.2.Using SPSS21.0 software,counting data were expressed as composition ratio,the characteristics of general case data between the two groups were compared by chi-square test,the survival rate of the two groups was estimated by Kaplan-Meier method and the survival curve was plotted,the univariate analysis was performed by binary logistic analysis,and the survival curve of the two groups was estimated by the method of Kaplan-Meier.Multivariate survival analysis using Cox.proportional hazard regression model,with P<0.05 as a statistical difference,to study the value of preoperative NLR in evaluating the prognosis of patients after radical resection of pancreatic adenocarcinoma.Result:1?Taking the median of NLR value as the cut-off point,all the patients were divided into two groups;2?The 1-year and 3-year survival rates were 89.2%,40.5%in low NLR group,65.7%and 11.4%in high NLR group,and one year after operation in low NLR group,and the 1-year and 3-year survival rates in high NLR group were 65.7%and 11.4%,respectively.The 3-year survival rate was higher than that in the high NLR group(P<0.05);3?Univariate analysis showed that preoperative NLR was an independent risk factor for 1-year survival rate of pancreatic cancer patients after radical resection,and the degree of tumor differentiation,preoperative CA19-9 level,preoperative NLR level and postoperative chemotherapy were associated with 3-year survival rate(P<0.05).4?Multivariate COX risk regression analysis suggested that preoperative and post-NLR,chemotherapy was a risk factor for 3-year survival rate(P<0.05).Conclusion:1.Preoperative NLR is related to the prognosis of patients with pancreatic cancer after operation.2.The prognosis of patients with pancreatic adenoma in high NLR group was worse than that in NLR group.High NLR could be used as a reference index to judge the poor prognosis of patients with pancreatic adenocarcinoma after operation.