Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma
Prognostic Value of Preoperative Nutritional and Immunological Factors in Patients with Pancreatic Ductal Adenocarcinoma
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DOI：
10.1245/s10434-018-6761-6
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发表时间：
2018-12-01
影响因子：
3.7
通讯作者：
Nakamura, Masafumi
中科院分区：
文献类型：
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作者：
Abe, Toshiya;Nakata, Kohei;Nakamura, Masafumi
背景已发现术前患者的营养和免疫因素与恶性肿瘤的预后结果相关。然而，这些因素在胰腺导管腺癌（PDAC）中的临床意义仍存在争议。目的本研究的目的是评估营养和免疫因素对预测PDAC患者生存的预后价值。方法分别对329例接受手术切除的PDAC患者和95例接受姑息性手术的患者进行回顾性研究，探讨肿瘤相关因素和患者相关因素（包括格拉斯哥）对预后的影响。预后评分（GPS）、改良GPS、预后营养指数（PNI）、中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值和淋巴细胞/单核细胞比值。结果在PDAC手术切除患者的多变量分析中，PNI是总生存期（OS）和无病生存期的独立因素。 PNI45 患者的中位 OS 显着短于 PNI>45 患者（分别为 17.5 和 36.2 个月；p5 显着短于 NLR5 患者（分别为 2.7 和 8.9 个月；p）
BackgroundPreoperative nutritional and immunological patient factors have been found to be associated with prognostic outcomes of malignant tumors; however, the clinical significance of these factors in pancreatic ductal adenocarcinoma (PDAC) remains controversial.ObjectiveThe aim of this study was to evaluate the prognostic value of nutritional and immunological factors in predicting survival of patients with PDAC.MethodsRetrospective studies of 329 patients who underwent surgical resection for PDAC and 95 patients who underwent palliative surgery were separately conducted to investigate the prognostic impact of tumor-related factors and patient-related factors, including Glasgow Prognostic Score (GPS), modified GPS, Prognostic Nutritional Index (PNI), neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio, and lymphocyte/monocyte ratio.ResultsIn multivariate analysis for patients with surgical resection for PDAC, PNI was an independent factor for overall survival (OS) and disease-free survival. The median OS of patients with PNI45 was significantly shorter than that of patients with PNI>45 (17.5 and 36.2months, respectively; p5 was significantly shorter than that of patients with NLR5 (2.7 and 8.9months, respectively; p