title: Preoperative neutrophil-to-lymphocyte ratio and tumor-related factors to predict lymph node metastasis in patients with pancreatic ductal adenocarcinoma (PDAC).
abstract: As a poor prognosis indicator in patients with pancreatic ductal adenocarcinoma (PDCA), lymph node (LN) metastasis is of great importance in treatment. Present study was performed to evaluate the predictive value of preoperative neutrophil-to-lymphocyte ratio (NLR), Platelet-to-lymphocyte ratio (PLR) and possible clinical parameters on the LN metastasis in PDCA patients. A total of 159 operable patients with PDCA were enrolled in our study. The clinical utility of NLR and other clinical parameters was evaluated by receiver operating characteristic (ROC) curves. Overall survival analysis indicated that LN metastasis is an independent prognostic factor. The logistic analysis was used to determine the independent parameters associated with LN metastasis. Ideal cutoff values for predicting LN metastasis are 2.12 for NLR and 130.96 for PLR according to the ROC curve. Multivariate analyses indicate that NLR (HR 2.588; 95% CI 1.246-5.376; P = 0.011), CA125 (HR 6.348; 95% CI 2.056-19.594; P = 0.001) and CA19-9 (HR 2.738; 95% CI 1.151-6.515; P = 0.023) are associated significantly with LN metastasis independently. Preoperative NLR, CA125 and CA19-9 are useful biomarkers for the prediction of LN metastasis in PDCA patients.
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Lianyuan
authors: L
authors: Tao
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Lingfu
authors: L
authors: Zhang
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Ying
authors: Y
authors: Peng
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Ming
authors: M
authors: Tao
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Gang
authors: G
authors: Li
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Dianrong
authors: D
authors: Xiu
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Chunhui
authors: C
authors: Yuan
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Chaolai
authors: C
authors: Ma
authors: Department of General Surgery, Peking University Third Hospital, Beijing, China.
authors: Bin
authors: B
authors: Jiang
mesh_terms: D000368:Aged; D021441:Carcinoma, Pancreatic Ductal / Q000097:blood* / Q000473:pathology; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D009504:Neutrophils / Q000473:pathology*; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000473:pathology; D011379:Prognosis; D016019:Survival Analysis
keywords: lymph node metastasis; neutrophil-to-lymphocyte ratio; pancreatic ductal adenocarcinoma; prognosis