The Relationship Between Metabolic and Inflammatory Parameters at the Time of Diagnosis and Disease Stage and Prognosis in Patients with Pancreatic Cancer.

Abstract

Introduction: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive tumor often accompanied by various metabolic abnormalities both before and after clinical diagnosis. Diagnosis at advanced stages significantly increases mortality risk. This study aimed to investigate the potential relationship between metabolic and inflammatory parameters at the time of diagnosis and disease stage, and their impact on prognosis in patients with pancreatic cancer. Materials and Methods: A total of 89 patients (43.8% male, 56.2% female) diagnosed with PDAC were included in the retrospective, single-center study. Disease stages at diagnosis that were categorized as stages 1-2 (resectable) and stages 3-4 (locally advanced and metastatic), height, weight, accompanying diseases, body mass index (BMI), inflammatory parameters (C-reactive protein (CRP), neutrophil/lymphocyte ratio (NLR), and metabolic parameters (glucose, HbA1c %, triglyceride, High-Density Lipoprotein [HDL]-cholesterol, Low-Density Lipoprotein [LDL]-cholesterol) were recorded. These parameters were compared between early and advanced stage patients, and their effect on one-year survival was evaluated. Results: The mean age of the patients was 62.7 years; 45.1% of the patients were in stages 1-2, while 48.3% were in stage 4. The one-year overall mortality rate was 32.6%, and the mortality rate was 52.1% in advanced stage (stages 3-4) patients and 9.8% in early stage (stages 1-2) patients. Mean CRP and NLR levels were significantly higher in patients who died compared to those who survived (7.4 vs. 4.4, p = 0.001; p = 0.000, respectively). Mean HDL-cholesterol level was lower in patients who died compared to survivors (34 mg/dL vs. 47.2 mg/dL, p = 0.001). Mean fasting blood glucose and HbA1c levels were higher in patients who died compared to survivors (167 mg/dL vs. 135 mg/dL, 7.5% vs. 6.6%; p = 0.008; p = 0.037, respectively). There were no significant differences in gender, BMI, presence of co-morbidities, triglyceride, or LDL-cholesterol levels between the groups. Conclusion: Recognizing clinical biomarkers predicting prognosis in PDAC could significantly contribute to disease management.