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PLoS One. 2016;11(1):e0145692.

More Accurate Prediction of Metastatic Pancreatic Cancer Patients' Survival with Prognostic Model Using Both Host Immunity and Tumor Metabolic Activity.

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제1저자 최연악 · 교신저자 오도연

PMID 26727470 PMC4699704 DOI 10.1371/journal.pone.0145692 IF 2.8 혈액종양내과
소속 (2)
  1. Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.
  2. Cancer Research Institute, Seoul National University College of Medicine, Seoul, Korea.

Abstract

INTRODUCTION Neutrophil to lymphocyte ratio (NLR) and standard uptake value (SUV) by 18F-FDG PET represent host immunity and tumor metabolic activity, respectively. We investigated NLR and maximum SUV (SUVmax) as prognostic markers in metastatic pancreatic cancer (MPC) patients who receive palliative chemotherapy.

METHODS We reviewed 396 MPC patients receiving palliative chemotherapy. NLR was obtained before and after the first cycle of chemotherapy. In 118 patients with PET prior to chemotherapy, SUVmax was collected. Cut-off values were determined by ROC curve.

RESULTS In multivariate analysis of all patients, NLR and change in NLR after the first cycle of chemotherapy (ΔNLR) were independent prognostic factors for overall survival (OS). We scored the risk considering NLR and ΔNLR and identified 4 risk groups with different prognosis (risk score 0 vs 1 vs 2 vs 3: OS 9.7 vs 7.9 vs 5.7 vs 2.6 months, HR 1 vs 1.329 vs 2.137 vs 7.915, respectively; P<0.001). In PET cohort, NLR and SUVmax were independently prognostic for OS. Prognostication model using both NLR and SUVmax could define 4 risk groups with different OS (risk score 0 vs 1 vs 2 vs 3: OS 11.8 vs 9.8 vs 7.2 vs 4.6 months, HR 1 vs 1.536 vs 2.958 vs 5.336, respectively; P<0.001).

CONCLUSIONS NLR and SUVmax as simple parameters of host immunity and metabolic activity of tumor cell, respectively, are independent prognostic factors for OS in MPC patients undergoing palliative chemotherapy.

Figures

Fig 1
Fig 1 Relationship of NLR and SUVmax with overall survival. (a) Overall survival according to NLR in all patients (N = 396): NLR <2.5: reference; NLR 2.5–4.4: HR 1.659, P<0.001; NLR ≥4.5: HR 2.926 (P<0.001). (b) Overall survival according to the risk scores of whole patients (N = 396): Group A (score 0), group B (score 1), group C (score 2), group D (score 3). Total risk score of patients were calculated by addition of each score of NLR (score 0, NLR <2.5; score 1, 2.5≤ NLR <4.5; score 2, NLR ≥4.5) and ΔNLR (score 0: ΔNLR <0; score 1: ΔNLR ≥0). (c) Overall survival according to NLR in PET cohort (N = 118): NLR <2.5: reference; NLR 2.5–4.4: HR 2.113, P = 0.002; NLR ≥4.5: HR 3.500, P<0.001. (d) Overall survival according to SUVmax in PET cohort (N = 118): SUVmax <4.5: reference; SUVmax ≥4.5: HR 1.845, P = 0.004. (e) Overall survival according to risk scores with NLR and SUVmax in PET cohort (N = 118): Group A (score 0), group B (score 1), group C (score 2), group D (score 3). Total risk score of patients were calculated by addition of each score of NLR (score 0, NLR <2.5; score 1, 2.5≤ NLR <4.5; score 2, NLR ≥4.5) and SUVmax (score 0: SUVmax <4.5; score 1: SUVmax ≥4.5).

그림 출처: PubMed Central 공개 논문 (PMC4699704)

Conflict of interest statement

Competing Interests:The authors have declared that no competing interests exist.

그 밖의 정보
출판 형태
Journal Article
저널
PloS one · eISSN 1932-6203
전자 출판
2016-01-04
MeSH
Cohort Studies · Female · Humans · Male · Middle Aged · Models, Biological* · Neoplasm Metastasis* · Pancreatic Neoplasms / immunology / metabolism / pathology · Prognosis · Survival Rate*
참고문헌
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