Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios

Asari, Sadaki; Matsumoto, Ippei; Toyama, Hirochika; Shinzeki, Makoto; Goto, Tadahiro; Ishida, Jun; Ajiki, Tetsuo; Fukumoto, Takumi; Ku, Yonson

doi:10.1007/s00595-015-1206-3

Cited by 61 publications

(42 citation statements)

References 41 publications

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“…Several inflammatory factors, such as plasma fibrinogen, neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR) are identified as useful indicators for predicting the prognosis in renal cell carcinoma, ovarian cancer, and hepatocellular carcinoma [4–6]. Recently, the preoperative platelet to lymphocyte ratio (PLR), which also reflects the degree of systemic inflammation, has been found to be linked to prognosis in patients with PC [7–9]. However, some studies failed to find correlation between PLR and prognosis of PC [10–12].…”

Section: Introductionmentioning

confidence: 99%

Preoperative platelet lymphocyte ratio as independent predictors of prognosis in pancreatic cancer: A systematic review and meta-analysis

et al. 2017

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Section: Introductionmentioning

confidence: 99%

Preoperative platelet lymphocyte ratio as independent predictors of prognosis in pancreatic cancer: A systematic review and meta-analysis

et al. 2017

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“…The clinical relevance of this ongoing inflammatory program is reflected in poor outcomes correlated with infiltrating inflammatory cells and the contributions of specific cell types are being increasingly elucidated (10, 11). For instance, neutrophil-lymphocyte ratio may represent a prognostic marker in PDA patients with a lower ratio representing improved prognosis and, despite the lack of a significant increase in the total cell number, B-cells have now been implicated in PDA progression through their ability to impact myeloid cell function (12–14). Meanwhile, single-agent inhibitors of immune checkpoints have not demonstrated substantial efficacy in PDA (15).…”

Section: Introductionmentioning

confidence: 99%

Immunologic and Metabolic Features of Pancreatic Ductal Adenocarcinoma Define Prognostic Subtypes of Disease

Hutcheson

Balaji

Porembka

et al. 2016

Clinical Cancer Research

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Purpose Pancreatic ductal adenocarcinoma (PDA) is associated with an immunosuppressive microenvironment that supports the growth of the malignancy as well as immune system evasion. Here we examine markers of immunosuppression in PDA within the context of the glycolytic tumor microenvironment, their inter-relationship with tumor biology and association with overall survival. Experimental design We utilized tissue microarrays consisting of 223 PDA patients annotated for clinical stage, tumor size, lymph node involvement, and survival. Expression of CD163, FoxP3, PD-L1, and MCT4 was assessed by immunohistochemistry and statistical associations were evaluated by univariate and multivariate analysis. Multi-marker subtypes were defined by Random Forest analysis. Mechanistic interactions were evaluated using PDA cell lines and models for myeloid differentiation. Results PDA exhibits discrete expression of CD163, FoxP3 and PD-L1 with modest individual significance. However, combined low expression of these markers was associated with improved prognosis (P =0.02). PDA tumor cells altered macrophage phenotype and function, which supported enhanced invasiveness in cell-based models. Lactate efflux mediated by MCT4 was associated with, and required for, the selective conversion of myeloid cells. Correspondingly, MCT4 expression correlated with immune markers in PDA cases, and increased the significance of prognostic subtypes (P = 0.002). Conclusions There exists a complex interplay between PDA tumor cells and the host immune system wherein immunosuppression is associated with negative outcome. MCT4 expression, representative of the glycolytic state of PDA, contributes to the phenotypic conversion of myeloid cells. Thus, metabolic status of PDA tumors is an important determinant of the immunosuppressive environment.

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“…Peripheral blood leukocyte count is a simple and valuable indicator that can reflect the degree of systemic inflammatory response in tumor patients [20], and elevations of NLR, PLR, and MLR are thought to reflect an exaggerated systemic inflammatory response [6-8]. Asari et al [6] found that high PLR could be used as an independent prognostic risk factor in resectable pancreatic ductal carcinoma. Ding et al [7] showed that NLR was an independent predictor for colon cancer patients.…”

Section: Discussionmentioning

confidence: 99%

“…The blood neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and monocyte-to-lymphocyte ratio (MLR) are systemic markers of inflammation. Strong evidence suggests that the NLR, PLR, and MLR are independent prognostic factors for survival in multiple tumors [6-8]. …”

Section: Introductionmentioning

confidence: 99%

The Value of COX-2, NF-κB, and Blood Routine Indexes in the Prognosis of Malignant Peritoneal Mesothelioma

Yin

Guo

et al. 2019

Oncol Res Treat

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Background/Aims: To investigate differences in blood routine indexes and the expression of cyclooxygenase-2 (COX-2) and nuclear factor-kappa B (NF-κB) in malignant peritoneal mesothelioma (MPeM) and their relationship with clinical prognosis. Methods: We investigated changes in blood routine indexes between the MPeM patients and healthy subjects and detected the expression of COX-2 and NF-κB in peritoneal tissues by a streptavidin-peroxidase immunohistochemistry method. Potential prognostic factors were analyzed including age, gender, white blood cell count (WBC), absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute platelet count (APC), absolute monocyte count (AMC), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), COX-2, and NF-κB. Cox regression model analysis established independent factors for the survival prognosis of the patients. Results: Compared with the control group, AMC, MXD%, ANC, neutrophilic granulocyte percentage (NEUT%), APC, NLR, MLR, and PLR were markedly increased (p < 0.05) in the MPeM group. The positivity rates for COX-2 and NF-κB expression were 59.4 and 44.9%, respectively. Single factor analyses indicated that PLR, NLR, MLR, COX-2, and NF-κB were factors that affected the overall survival of MPeM patients, but multivariate analyses identified MLR and COX-2 as independent prognostic factors. Conclusions: High blood levels of MLR and COX-2 are adverse prognostic factors for patients with MPeM.

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Preoperative independent prognostic factors in patients with borderline resectable pancreatic ductal adenocarcinoma following curative resection: the neutrophil-lymphocyte and platelet-lymphocyte ratios

Abstract: Higher preoperative NLR and PLR can be independent predictive risk factors in BR-PDAC patients following curative resection.

Cited by 61 publications

References 41 publications

Preoperative platelet lymphocyte ratio as independent predictors of prognosis in pancreatic cancer: A systematic review and meta-analysis

Preoperative platelet lymphocyte ratio as independent predictors of prognosis in pancreatic cancer: A systematic review and meta-analysis

Immunologic and Metabolic Features of Pancreatic Ductal Adenocarcinoma Define Prognostic Subtypes of Disease

The Value of COX-2, NF-κB, and Blood Routine Indexes in the Prognosis of Malignant Peritoneal Mesothelioma

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