title: Blood neutrophil-lymphocyte ratio predicts survival in patients with advanced pancreatic cancer treated with chemotherapy.
abstract: BACKGROUND
  Although a high neutrophil-to-lymphocyte ratio (NLR) has been reported to be a predictor of poor survival in patients with pancreatic cancers, its prognostic role in patients with advanced pancreatic cancer undergoing chemotherapy remains unclear. This study was performed to determine the prognostic role of NLR in patients with advanced pancreatic cancer undergoing chemotherapy.
  
  
  METHODS
  We retrospectively enrolled 403 patients undergoing chemotherapy for advanced pancreatic adenocarcinoma from 2002 to 2013. Univariate and multivariate analyses were performed to identify clinicopathological predictors of overall survival including baseline NLR (NLR before chemotherapy) and postchemotherapy NLR change (NLR change before and after one cycle of chemotherapy), using the Cox proportional hazards model. Clinicopathological characteristics related to baseline NLR and postchemotherapy NLR change were evaluated.
  
  
  RESULTS
  Univariate and multivariate analyses showed that both baseline NLR (NLR ≥ 3.1 vs. NLR < 3.1, hazard ratio [HR] = 1.42; P = 0.001) and postchemotherapy NLR change (NLR ≥ 3.1 and increased vs. NLR < 3.1 and decreased, HR = 2.39; P = 0.000) were independent prognostic factors in overall survival. NLR ≥ 3.1 before chemotherapy and NLR postchemotherapy change were significantly correlated with distant metastasis, serum CA19-9 levels, and serum albumin levels.
  
  
  CONCLUSIONS
  Baseline NLR and postchemotherapy NLR change may serve as potential biomarkers for overall survival in patients with advanced pancreatic cancer undergoing chemotherapy.
authors.affiliation: Department of Pancreatic and Hepatobiliary Surgery, Fudan University Shanghai Cancer Center, Shanghai, Peoples Republic of China.
authors.forename: Guopei
authors.initials: G
authors.lastname: Luo
authors.forename: Meng
authors.initials: M
authors.lastname: Guo
authors.forename: Zuqiang
authors.initials: Z
authors.lastname: Liu
authors.forename: Zhiwen
authors.initials: Z
authors.lastname: Xiao
authors.forename: Kaizhou
authors.initials: K
authors.lastname: Jin
authors.forename: Jiang
authors.initials: J
authors.lastname: Long
authors.forename: Liang
authors.initials: L
authors.lastname: Liu
authors.forename: Chen
authors.initials: C
authors.lastname: Liu
authors.forename: Jin
authors.initials: J
authors.lastname: Xu
authors.forename: Quanxing
authors.initials: Q
authors.lastname: Ni
authors.forename: Xianjun
authors.initials: X
authors.lastname: Yu
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy; D000971:Antineoplastic Combined Chemotherapy Protocols; D005260:Female; D006801:Humans; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D009504:Neutrophils; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000188:drug therapy; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis