The combination of systemic inflammation-based marker NLR and circulating regulatory T cells predicts the prognosis of resectable pancreatic cancer patients
The combination of systemic inflammation-based marker NLR and circulating regulatory T cells predicts the prognosis of resectable pancreatic cancer patients
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基于全身炎症的标记物 NLR 和循环调节性 T 细胞的结合可预测可切除胰腺癌患者的预后
DOI：
10.1016/j.pan.2016.09.007
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发表时间：
2016-11-01
期刊：
影响因子：
3.6
通讯作者：
Liu, Chen
中科院分区：
文献类型：
--
作者：
Cheng, He;Luo, Guopei;Liu, Chen
背景：全身炎症反应和免疫损伤与胰腺癌等多种肿瘤的发生发展密切相关。在这项研究中，我们评估了循环炎症因子和循环调节性T细胞(Tregs)作为免疫抑制标志物在中国可切除胰腺癌患者中的作用。方法：样本来自2010年6月至2014年4月间接受潜在根治性手术的195例病理I/II期胰腺癌患者。结果：单因素分析显示，中性粒细胞-淋巴细胞比率(NLR)、TNM分期、分化程度、化疗、CA19-9水平及Tregs的存在与胰腺癌患者的总生存率显著相关。多因素分析显示，NLR(p=0.001，HR=0.538)、TNM分期(p=0.004，HR=0.593)、分化程度(p=0.011，HR=0.46)、化疗(p=0.006，HR=0.516)和Tregs(p=0.001，HR=0.558)是影响预后的独立因素。有趣的是，我们还发现，高水平的NLR和高比例的Tregs(p<；0.001，HR=3.521)与较差的生存密切相关，与同时存在低水平NLR和Tregs的患者相比，死亡风险增加3.5%以上。结论：术前NLR和循环调节性T细胞是可切除胰腺癌患者总体生存的潜在独立预后因素。根据Tregs的测量，手术前NLR水平高和免疫状态差与极差的预后有关。(C)2016年，由爱思唯尔公司代表IAP和EPC出版。
Background: The systemic inflammation response and immune impairment are closely related to the development and progression of various tumours, such as pancreatic cancer. In this study, we evaluated circulating inflammation factors and circulating regulatory T cells (Tregs) as markers of immunosuppression in a cohort of Chinese patients with resectable pancreatic cancer.Methods: Samples were retrospectively collected from a series of 195 pathological stage I/II pancreatic cancer patients who underwent potentially curative surgery between June 2010 and April 2014. To examine the prognostic factors, circulating systemic inflammation-based markers and Tregs, detected by flow cytometry, were analysed.Results: Univariate analyses revealed that the neutrophil-lymphocyte ratio (NLR), TNM stage, differentiation, chemotherapy, CA19-9 levels and presence of Tregs are significantly associated with overall survival in patients with resectable pancreatic cancers. NLR (p = 0.001, HR = 0.538), TNM stage (p = 0.004, HR = 0.593), differentiation (p = 0.011, HR = 0.46), chemotherapy (p = 0.006, HR = 0.516) and Tregs (p = 0.001, HR = 0.558) are identified as independent prognostic markers by multivariate analyses. Interestingly, we also found that high NLR levels combined with a high proportion of Tregs (p < 0.001, HR = 3.521) correlate strongly with worse survival, with a greater than 3.5 fold increased risk of death compared with those with concurrent low levels of NLR and Tregs.Conclusions: The preoperative NLR and circulating regulatory T cells are potentially independent prognostic factors for overall survival in resectable pancreatic cancer patients. High NLR levels combined with poor immune state before surgery, as measured by Tregs, are associated with an extremely poor prognosis. (C) 2016 Published by Elsevier B.V. on behalf of IAP and EPC.