title: Prognostic value of neutrophil-lymphocyte ratio and level of C-reactive protein in a large cohort of pancreatic cancer patients: a retrospective study in a single institute in Japan.
abstract: OBJECTIVE
  Recent studies suggest that systemic inflammatory response is closely associated with cancer patient prognosis. Although several inflammatory prognostic markers have been proposed, the data to support their validity are lacking in large Japanese cohorts.
  
  
  METHODS
  This is a retrospective study to examine the prognostic value of inflammatory markers, such as C-reactive protein, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and modified Glasgow prognostic scale, in pancreatic cancer. Selection criteria were admittance to hospital between January 2008 and December 2012, histologically confirmed adenocarcinoma, diagnosis of invasive ductal pancreatic cancer compatible by computed tomography imaging, and followed-up until death or for 180 days or longer. The primary end point was overall survival, which was measured from the day of histological diagnosis.
  
  
  RESULTS
  There were 440 patients who met the selection criteria. Of the 440 cases, 200 (45.5%) received curative resection (166 Stage I/II and 34 Stage III patients), 237 (53.9%) received chemotherapy (4 Stage I/II, 92 Stage III and 141 Stage IV patients), and the remaining 3 received palliative care. Univariate and multivariate regression analyses revealed that advanced computed tomography stage, high level of C-reactive protein (0.45 mg/dl or greater), neutrophil-lymphocyte ratio (2.0 or greater) and CA19-9 level (1000 U/ml or greater) were significantly associated with worse prognosis.
  
  
  CONCLUSIONS
  We verified the results of previous studies, and showed that neutrophil-lymphocyte ratio and C-reactive protein also had prognostic value in a large Japanese PC cohort.
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku dai.inoue@jfcr.or.jp.
authors.forename: Dai
authors.initials: D
authors.lastname: Inoue
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku.
authors.forename: Masato
authors.initials: M
authors.lastname: Ozaka
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku.
authors.forename: Masato
authors.initials: M
authors.lastname: Matsuyama
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku.
authors.forename: Ikuhiro
authors.initials: I
authors.lastname: Yamada
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku.
authors.forename: Koichi
authors.initials: K
authors.lastname: Takano
authors.affiliation: Gastroenterological Surgery, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Saiura
authors.affiliation: Gastroenterological Internal Medicine, Cancer Institution Hospital of Japanese Foundation for Cancer Research, Koto-ku.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishii
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000378:metabolism*; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D018655:Lymphocyte Count; D008214:Lymphocytes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000473:pathology; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein
keywords: CRP; NLR; PLR; mGPS; survival