title: Platelet × CRP Multiplier Value as an Indicator of Poor Prognosis in Patients With Resectable Pancreatic Cancer.
abstract: Thrombocytosis in patients with various cancers has been considered a parameter for poor prognosis; however, its contribution to pancreatic cancer remains controversial.
  
  
  
  Potential preoperative prognostic parameters (platelets, neutrophils, lymphocytes, the platelet-lymphocyte ratio, the neutrophil-lymphocyte ratio, the serum C-reactive protein [CRP], and carbohydrate antigen 19-9) were retrospectively analyzed in 95 patients with pancreatic cancer. Cutoff values were defined according to receiver operating characteristic curve analysis, and median survival times (MSTs) were compared.
  
  
  
  Median survival times (days) significantly differed according to platelet count (high [552] vs low [735], P = 0.017), CRP (high [471] vs low [750], P = 0.001), and carbohydrate antigen 19-9 level (high [639] vs low [765], P = 0.021), whereas there was no difference in the platelet-lymphocyte ratio and the neutrophil-lymphocyte ratio. Multivariate analysis identified thrombocytosis (hazard ratio, 2.015) and CRP level (hazard ratio, 1.771) as independent prognostic factors. The combinatory effects of platelets and the inflammatory response using a platelet × CRP multiplier value could effectively distinguished the MSTs (days) of patients with pancreatic cancer (high [482] vs low [812], P < 0.001).
  
  
  
  Thrombocytosis and CRP influenced pancreatic cancer patient prognosis. Platelet × CRP multiplier is assumed as a useful parameter that reflects the contribution of activated platelets to cancer progression.
authors.affiliation: From the Department of Surgery, Division of Gastroenterological and Hepatobiliary Surgery, and Organ Transplantation, University of Tsukuba, Tsukuba, Ibaraki, Japan.
authors.forename: Ryoichi
authors.initials: R
authors.lastname: Miyamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Oda
authors.forename: Shinji
authors.initials: S
authors.lastname: Hashimoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Keisuke
authors.initials: K
authors.lastname: Kohno
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Akashi
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohara
authors.forename: Keiichi
authors.initials: K
authors.lastname: Yamada
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Enomoto
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Ohkohchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002097:C-Reactive Protein / Q000032:analysis*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D015999:Multivariate Analysis; D010190:Pancreatic Neoplasms / Q000097:blood* / Q000175:diagnosis*; D010976:Platelet Count; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012372:ROC Curve; D012189:Retrospective Studies
chemical_list: D002097:C-Reactive Protein