title: Validation of the pretreatment neutrophil-lymphocyte ratio as a predictor of overall survival in a cohort of patients with pancreatic ductal adenocarcinoma.
abstract: OBJECTIVE
  The circulating neutrophil-lymphocyte ratio (NLR) has been shown to be a prognostic factor for a variety of tumors. In this study, we evaluated the prognostic significance of NLR in a large cohort of Chinese patients with pancreatic ductal adenocarcinomas (PDACs).
  
  
  METHODS
  A total of 381 patients with PDAC who underwent potentially curative surgery were recruited from 2 centers in Shanghai, China, between January 2004 and September 2011. Analysis of overall survival (OS) was performed using the Kaplan-Meier and log-rank tests and the Cox proportional hazards regression model.
  
  
  RESULTS
  The most optimal cutoff of NLR was NLR 2.0 or greater, and the NLR was divided into 2 groups: high (≥ 2.0) and low (< 2.0). The high NLR (≥ 2.0) was associated with advanced UICC (Union for International Cancer Control) stages, p T stage, lymphoid node invasion, and poorer tumor differentiation. Multivariate analysis identified increased NLR as an independent prognostic factor for OS (hazard ratio = 1.51; 95 % confidence interval, 1.15-1.99; P = 0.003). Furthermore, neutrophil counts rather than lymphocyte counts were associated with OS of PDAC.
  
  
  CONCLUSIONS
  The pretreatment NLR is a simple and useful potential biomarker for OS in patients with PDAC after curative resection.
authors.affiliation: From the *Department of Gastroenterology, Ruijin Hospital, Shanghai Jiaotong University; and Departments of †Gastroenterology and ‡Information, Changhai Hospital of Second Military Medical University, Shanghai, China.
authors.forename: Qiwen
authors.initials: Q
authors.lastname: Ben
authors.forename: Wei
authors.initials: W
authors.lastname: An
authors.forename: Lifu
authors.initials: L
authors.lastname: Wang
authors.forename: Weiyi
authors.initials: W
authors.lastname: Wang
authors.forename: Lei
authors.initials: L
authors.lastname: Yu
authors.forename: Yaozong
authors.initials: Y
authors.lastname: Yuan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D002681:China; D016208:Databases, Factual; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D018655:Lymphocyte Count; D008214:Lymphocytes; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009504:Neutrophils; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology / Q000628:therapy; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult