Markers of Systemic Inflammatory Response are Prognostic Factors in Patients with Pancreatic Neuroendocrine Tumors (PNETs): A Prospective Analysis.
Markers of Systemic Inflammatory Response are Prognostic Factors in Patients with Pancreatic Neuroendocrine Tumors (PNETs): A Prospective Analysis.
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DOI：
10.1245/s10434-017-6241-4
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发表时间：
2018-01
影响因子：
3.7
通讯作者：
Kebebew E
中科院分区：
文献类型：
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作者：
Gaitanidis A;Patel D;Nilubol N;Tirosh A;Sadowski S;Kebebew E
胰腺神经内分泌肿瘤（PNET）的预后和行为各不相同，即使在同一阶段或肿瘤级别也可能存在差异。全身炎症反应的标志物很容易获得并且价格低廉，并且已被证明是多种癌症的预后因素。本研究的目的是评估 PNET 患者全身炎症反应标志物的预后效用。对 97 名 PNET 患者进行了一项前瞻性研究（中位随访 15 个月，范围 12-73 个月）。在基线和术前计算中性粒细胞与淋巴细胞比率（NLR）和淋巴细胞与单核细胞比率（LMR）。主要结局指标是治愈性切除后的无进展生存期（PFS）和无复发生存期（RFS）。在所有患者中，NLR>2.3 [风险比 (HR) 2.53，95% 置信区间 (CI) 1.05–6.08，p = 0.038] 和远处转移的存在（HR 2.8，95% CI 1.26–6.21，p = 0.012）是疾病进展的独立预测因素。在研究期间未接受手术的患者中，血小板与淋巴细胞比 (PLR)>160.9（HR 5.86，95% CI 1.27-27.08，p = 0.023）和平均血小板体积>10.75 fL（HR 6.63，95% CI 1.6-27.48，p = 0.009）与较差的 PFS 独立相关关于多变量分析。在接受完全切除的患者中，LMR<3.46 与较差的 RFS 相关（HR 9.72，95% CI 1.19–79.42，p = 0.034）。基线时 PLR>160.9 和 MPV>10.75 fL 是疾病进展的独立预测因子，而 LMR<3.46 是 PNET 患者完全切除后肿瘤复发的独立预测因子。
The prognosis and behavior of pancreatic neuroendocrine tumors (PNETs) vary and may be divergent even at the same stage or tumor grade. Markers of systemic inflammatory response are readily available and are inexpensive, and have been shown to be prognostic factors in several cancers. The aim of this study was to evaluate the prognostic utility of markers of systemic inflammatory response in patients with PNETs. A prospective study of 97 patients with PNETs was performed (median follow-up of 15 months, range 12–73 months). Neutrophil-to-lymphocyte ratios (NLRs) and lymphocyte-to-monocyte ratios (LMRs) were calculated at baseline and preoperatively. The primary outcome measures were progression-free survival (PFS) and recurrence-free survival (RFS) after curative resection. Among all patients, an NLR>2.3 [hazard ratio (HR) 2.53, 95% confidence interval (CI) 1.05–6.08, p = 0.038] and the presence of distant metastases (HR 2.8, 95% CI 1.26–6.21, p = 0.012) were independent predictors of disease progression. Among patients who did not undergo surgery during the study period, both platelet-to-lymphocyte ratio (PLR)>160.9 (HR 5.86, 95% CI 1.27–27.08, p = 0.023) and mean platelet volume>10.75 fL (HR 6.63, 95% CI 1.6–27.48, p = 0.009) were independently associated with worse PFS on multivariable analysis. Among patients who underwent complete resection, an LMR<3.46 was associated with a worse RFS (HR 9.72, 95% CI 1.19–79.42, p = 0.034). PLR>160.9 and an MPV>10.75 fL at baseline are independent predictors of disease progression, while an LMR<3.46 is an independent predictor of tumor recurrence after complete resection in patients with PNETs.