Preoperative platelet-to-lymphocyte ratio improves the performance of the international consensus guidelines in predicting malignant pancreatic cystic neoplasms

Goh, Brian K. P.; Teo, Jin‐Yao; Allen, John C.; Tan, Dawn; Chan, Chung‐Yip; Lee, Ser‐Yee; Tai, David; Thng, Choon-Hua; Cheow, Peng‐Chung; Chow, Pierce K. H.; Ooi, London Lucien; Chung, Alexander Yaw Fui

doi:10.1016/j.pan.2016.06.660

Cited by 11 publications

(7 citation statements)

References 21 publications

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“…8,9 Recently, both markers have also been shown associated with prognosis in pancreatic cystic neoplasms (PCNs). 10,11 However, the association between systemic inflammatory markers and biological behavior of SPTP has not been studied.…”

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confidence: 99%

“…Serum tumor markers such as CEA, CA19-9, and CA125 were all within normal ranges in them, indicating no value of these markers in predicting malignant SPTP. Previous studies have assessed the prognostic role of NLR in patients with many types of pancreatic neoplasms, demonstrating that high NLR was an effective predictor of malignancy 10,15,16. Goh et al 10 showed that high PLR but not NLR was an independent predictor of malignant PCNs.…”

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confidence: 99%

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Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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Background Systemic inflammatory markers such as neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) have been shown to be prognostic for many types of pancreatic malignancy. The aim of this study was to evaluate the prognostic role of these markers in patients with solid pseudopapillary tumor of the pancreas (SPTP). Methods Patients who underwent surgical resection for histologically confirmed SPTP were retrospectively reviewed in our institution. Preoperative NLR and PLR were calculated. Clinicopathologic data were correlated with the presence of malignant potential and recurrence‐free survival (RFS). Results A total of 113 patients with SPTP were included in this study. Of them, 23 were men and 90 were women, with a median age of 35 years (interquartile range, 25‐44). The optimal cut‐off values for malignant SPTP were 3.22 for NLR, and 75.5 for PLR, respectively. Univariate analysis showed that high NLR (>3.22) and white blood cell count more than 9.96 × 109/L were predictive of a malignant SPTP. Meanwhile, high NLR (P = 0.001) and age more than 35 years (P = 0.026) were associated with worse RFS. On multivariable analyses, high NLR was the only independent predictor of malignant SPTP (odd ratio 6.871; 95% confidence interval [CI], 1.482‐31.864; P = 0.014) and RFS (hazard ratio 12.633; 95% CI, 1.758‐90.790; P = 0.012). Conclusions This study highlights the supportive role of preoperative NLR in predicting malignancy and RFS of SPTP patients. Further studies including a larger cohort of patients are needed to corroborate our findings.

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confidence: 99%

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confidence: 99%

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Yang

Bao

Zhou

et al. 2019

Journal of Surgical Oncology

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“…In a series of 318 patients with pancreatic cystic neoplasms (including 86 IPMNs), Goh et al [ 27 ] found that a high preoperative PLR, but not the NLR, was an independent predictor of malignancy. They also found that adding the PLR to the ICG criteria improved the accuracy of the latter in detecting cases of invasive carcinoma.…”

Section: Discussionmentioning

confidence: 99%

“…A systemic inflammatory response has increasingly been recognized as an important factor in the process of carcinogenesis and a cancer’s subsequent behavior, with tumor growth appearing to be directly proportional to the degree of inflammation [ 28 , 29 ]. The NLR [ 23 , 30 , 31 ] or PLR [ 27 ], or both [ 32 ] have been suggested as useful prognostic markers in patients with pancreatic cancer. A systematic review and meta-analysis conducted by Zhou et al [ 33 ] on 8252 patients with pancreatic cancer showed that a low NLR was significantly associated with better disease-free and overall survival rates than a high NLR.…”

Section: Discussionmentioning

confidence: 99%

The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas

Serafini

Friziero

Sperti

et al. 2021

JCM

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There is growing evidence to indicate that inflammatory reactions are involved in cancer progression. The aim of this study is to assess the significance of systemic inflammatory biomarkers, such as the neutrophil-to-lymphocyte ratio (NLR), the platelet-to-lymphocyte ratio (PLR), the ratio of C-reactive protein to albumin ratio (CAR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGps) in the diagnosis and prognosis of malignant intraductal papillary mucinous neoplasms (IPMNs) of the pancreas. Data were obtained from a retrospective analysis of patients who underwent pancreatic resection for IPMNs from January 2005 to December 2015. Univariate and multivariate analyses were performed, considering preoperative inflammatory biomarkers, clinicopathological variables, and imaging features. Eighty-three patients with histologically proven IPMNs of the pancreas were included in the study, 37 cases of low-grade or intermediate dysplasia and 46 cases of high-grade dysplasia (HGD) or invasive carcinoma. Univariate analysis showed that obstructive jaundice (p = 0.02) and a CAR of > 0.083 (p = 0.001) were predictors of malignancy. On multivariate analysis, only the CAR was a statistically significant independent predictor of HGD or invasive carcinoma in pancreatic IPMNs, identifying a subgroup of patients with a poor prognosis. Combining the CAR with patients’ imaging findings, clinical features and tumor markers can be useful in the clinical management of IPMNs. Their value should be tested in prospective studies.

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“…Moreover, some studies in the recent years have reported significant differences between right-sided colon cancers (RCC) and leftsided colon cancers (LCC), according to the inflammatory ratios values, with different survival and prognosis due to them (30,31). In fact, an increasing evidence of the potential usefulness of these markers for prognostic prediction of several cancers such as gastric, lung, ovarian or pancreatic, has been reported in the last years (32)(33)(34)(35)(36), but their capacity as tools for cancer diagnosis has been barely investigated. The diagnostic efficacy of these indices in CRC remains unknown, and only a few studies have been reported (10,37,38).…”

Section: Introductionmentioning

confidence: 99%

Blood-Cell-Based Inflammatory Markers as a Useful Tool for Early Diagnosis in Colorectal Cancer

et al. 2022

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BackgroundSystemic inflammation seems to be involved in the pathogenetic pathways of colorectal cancer (CRC). Analytical markers that reflect the inflammatory status, such as neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR) or systemic immune-inflammation index (SII), have been proposed as tools for the prognosis of CRC. Nevertheless, their use for diagnosis has been scarcely investigated.AimsTo analyze the ability of these markers and of a new marker combining SII and hemoglobin concentration, named NP/LHb = [neutrophils x platelets]/[lymphocytes x hemoglobin], as tools for CRC diagnosis. Furthermore, we studied their association with CRC-related variables.MethodsCase-control study including 214 CRC patients and 214 controls without CRC, matched by age (±5 years) and sex. We collected demographic, CRC-related and laboratory variables to calculate NLR, PLR, SII, and NP/LHb. In the case group, the laboratory variables were collected at two different period times, 6 months (IQR 4–8) before the CRC diagnosis and at the time of the diagnosis. ROC analysis was performed to evaluate the discriminatory accuracy of each index and we calculated Se, Sp, PPV, NPV, and OR to identify the diagnostic performance of each positive marker.ResultsNP/LHb showed high Sp (92.06%) and PPV (87.50%) to diagnose patients with CRC. This index exhibited an OR of 14.52 (8.26–25.52) and the best area under the curve (AUC: 0.78) for a positive CRC diagnosis. We found significant differences in all indices according to the presence of CRC, observing the highest values in CRC patients at time of diagnosis, in comparison with the analysis performed in the previous months to diagnosis or with control patients. There were significant differences in all ratios according to TNM stages (p < 0.05). PLR, SII and NP/LHb (but not NLR) showed significant differences according to tumor location (p < 0.05). Right-sided colon cancers presented the highest values, in comparison with left-sided and rectal cancers.ConclusionsSystemic inflammatory cell ratios (especially NP/LHb) change over time with the development of CRC, so they could be useful in its early diagnosis. We suggest that they could be routinely measured in patients with suspicion of CRC, to identify those ones with a higher risk of cancer, considering the high positive predictive value they have shown in our study.

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Preoperative platelet-to-lymphocyte ratio improves the performance of the international consensus guidelines in predicting malignant pancreatic cystic neoplasms

Cited by 11 publications

References 21 publications

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

Preoperative neutrophil‐to‐lymphocyte ratio predicts malignancy and recurrence‐free survival of solid pseudopapillary tumor of the pancreas

The Ratio of C-Reactive Protein to Albumin Is an Independent Predictor of Malignant Intraductal Papillary Mucinous Neoplasms of the Pancreas

Blood-Cell-Based Inflammatory Markers as a Useful Tool for Early Diagnosis in Colorectal Cancer

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