title: Preoperative hematologic markers as independent predictors of prognosis in resected pancreatic ductal adenocarcinoma: neutrophil-lymphocyte versus platelet-lymphocyte ratio.
abstract: BACKGROUND
  The objective of this study was to investigate whether the preoperative hematologic markers, the platelet-lymphocyte ratio (PLR), or the neutrophil-lymphocyte ratio (NLR) ratio are significant prognostic indicators in resected pancreatic ductal adenocarcinoma.
  
  
  METHODS
  A total of 84 patients undergoing pancreatoduodenectomy for pancreatic ductal adenocarcinoma over a 10-year period were identified from a retrospectively maintained database.
  
  
  RESULTS
  The preoperative NLR was found to be a significant prognostic marker (P = .023), whereas PLR had no significant relationship with survival (P = .642) using univariate Cox survival analysis. The median overall survival in patients with an NLR of < or =3.0 (n = 55) was 13.7, 17.0 months in those with an NLR of 3.0 to 4.0 (n = 17) and 5.9 months in patients with a value of >4.0 (n = 12) (log rank, P = .016). The NLR retained its significance on multivariate analysis (P = .039) along with resection margin status (P = .001).
  
  
  CONCLUSIONS
  The preoperative NLR represents a significant independent prognostic indicator in patients with resected pancreatic ductal adenocarcinoma, whereas PLR does not.
authors.affiliation: University of Nottingham Medical School, Derby City General Hospital, UK. imran.bhatti@nottingham.ac.uk
authors.forename: Imran
authors.initials: I
authors.lastname: Bhatti
authors.forename: Oliver
authors.initials: O
authors.lastname: Peacock
authors.forename: Gareth
authors.initials: G
authors.lastname: Lloyd
authors.forename: Michael
authors.initials: M
authors.lastname: Larvin
authors.forename: Richard I
authors.initials: RI
authors.lastname: Hall
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D005260:Female; D006801:Humans; D007958:Leukocyte Count; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D016577:Pancreaticoduodenectomy; D010976:Platelet Count; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D015415:Biomarkers