{"title":"预测胰腺癌生存的炎症标志物：一项系统回顾和荟萃分析。","authors":"Rinrada Worapongpaiboon, Noppachai Siranart, Patavee Pajareya, Somkiat Phutinart","doi":"10.1016/j.pan.2025.02.014","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Determining an accurate prognosis for pancreatic cancer (PC) can pose significant challenges. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) has been used as prognostic factors to predict outcomes in patients with gastrointestinal cancer. This study aims to reveal the prognostic value of NLR and PLR on survival outcomes and risk of metastasis in PC.</p><p><strong>Methods: </strong>NLR and PLR was investigated for its potential to predict survival outcomes in pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumor (PNET). For pancreatic cystic neoplasm (PCN), we investigated the potential for inflammatory markers to predict malignancy. Subgroup analysis was performed for tumor resectability, marker cut-off value (COV), and conducted location. Hazard ratios (HRs) and odds ratios (ORs) were pooled and analyzed using a random-effects model.</p><p><strong>Results: </strong>A total of 105 studies included with a total of 20,138 patients. In PDAC, elevated NLR levels were significantly associated with poorer outcomes of overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS) in multivariable analysis (HR 1.79, 1.74, and 1.91, respectively). Similarly, elevated PLR levels in PDAC were also associated with poorer OS and RFS in multivariable analysis (HR 1.33 and 1.94), respectively. For PNET, NLR was significantly associated with OS and RFS in multivariable analysis (HR 2.57 and 3.05, respectively). Furthermore, NLR and PLR show significant association with malignancy in PCN (OR 3.07 and HR 2.42, respectively).</p><p><strong>Conclusion: </strong>NLR and PLR effectively predicted PC outcomes and hold potential for evaluating therapeutic responses and identifying candidates for additional treatment strategies in advanced disease.</p>","PeriodicalId":19976,"journal":{"name":"Pancreatology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Inflammatory markers in predicting survival in pancreatic cancer: A Systematic review and Meta-Analysis.\",\"authors\":\"Rinrada Worapongpaiboon, Noppachai Siranart, Patavee Pajareya, Somkiat Phutinart\",\"doi\":\"10.1016/j.pan.2025.02.014\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Determining an accurate prognosis for pancreatic cancer (PC) can pose significant challenges. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) has been used as prognostic factors to predict outcomes in patients with gastrointestinal cancer. This study aims to reveal the prognostic value of NLR and PLR on survival outcomes and risk of metastasis in PC.</p><p><strong>Methods: </strong>NLR and PLR was investigated for its potential to predict survival outcomes in pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumor (PNET). For pancreatic cystic neoplasm (PCN), we investigated the potential for inflammatory markers to predict malignancy. Subgroup analysis was performed for tumor resectability, marker cut-off value (COV), and conducted location. Hazard ratios (HRs) and odds ratios (ORs) were pooled and analyzed using a random-effects model.</p><p><strong>Results: </strong>A total of 105 studies included with a total of 20,138 patients. In PDAC, elevated NLR levels were significantly associated with poorer outcomes of overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS) in multivariable analysis (HR 1.79, 1.74, and 1.91, respectively). Similarly, elevated PLR levels in PDAC were also associated with poorer OS and RFS in multivariable analysis (HR 1.33 and 1.94), respectively. For PNET, NLR was significantly associated with OS and RFS in multivariable analysis (HR 2.57 and 3.05, respectively). Furthermore, NLR and PLR show significant association with malignancy in PCN (OR 3.07 and HR 2.42, respectively).</p><p><strong>Conclusion: </strong>NLR and PLR effectively predicted PC outcomes and hold potential for evaluating therapeutic responses and identifying candidates for additional treatment strategies in advanced disease.</p>\",\"PeriodicalId\":19976,\"journal\":{\"name\":\"Pancreatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-02-27\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Pancreatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.pan.2025.02.014\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Pancreatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.pan.2025.02.014","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Inflammatory markers in predicting survival in pancreatic cancer: A Systematic review and Meta-Analysis.
Introduction: Determining an accurate prognosis for pancreatic cancer (PC) can pose significant challenges. Neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) has been used as prognostic factors to predict outcomes in patients with gastrointestinal cancer. This study aims to reveal the prognostic value of NLR and PLR on survival outcomes and risk of metastasis in PC.
Methods: NLR and PLR was investigated for its potential to predict survival outcomes in pancreatic ductal adenocarcinoma (PDAC) and pancreatic neuroendocrine tumor (PNET). For pancreatic cystic neoplasm (PCN), we investigated the potential for inflammatory markers to predict malignancy. Subgroup analysis was performed for tumor resectability, marker cut-off value (COV), and conducted location. Hazard ratios (HRs) and odds ratios (ORs) were pooled and analyzed using a random-effects model.
Results: A total of 105 studies included with a total of 20,138 patients. In PDAC, elevated NLR levels were significantly associated with poorer outcomes of overall survival (OS), progression-free survival (PFS), and recurrence-free survival (RFS) in multivariable analysis (HR 1.79, 1.74, and 1.91, respectively). Similarly, elevated PLR levels in PDAC were also associated with poorer OS and RFS in multivariable analysis (HR 1.33 and 1.94), respectively. For PNET, NLR was significantly associated with OS and RFS in multivariable analysis (HR 2.57 and 3.05, respectively). Furthermore, NLR and PLR show significant association with malignancy in PCN (OR 3.07 and HR 2.42, respectively).
Conclusion: NLR and PLR effectively predicted PC outcomes and hold potential for evaluating therapeutic responses and identifying candidates for additional treatment strategies in advanced disease.
期刊介绍：
Pancreatology is the official journal of the International Association of Pancreatology (IAP), the European Pancreatic Club (EPC) and several national societies and study groups around the world. Dedicated to the understanding and treatment of exocrine as well as endocrine pancreatic disease, this multidisciplinary periodical publishes original basic, translational and clinical pancreatic research from a range of fields including gastroenterology, oncology, surgery, pharmacology, cellular and molecular biology as well as endocrinology, immunology and epidemiology. Readers can expect to gain new insights into pancreatic physiology and into the pathogenesis, diagnosis, therapeutic approaches and prognosis of pancreatic diseases. The journal features original articles, case reports, consensus guidelines and topical, cutting edge reviews, thus representing a source of valuable, novel information for clinical and basic researchers alike.
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