Neutrophil-to-Lymphocyte Ratio as a Predictor of Invasive Carcinoma in Patients With Intraductal Papillary Mucinous Neoplasms of the Pancreas.

Autor:	McIntyre CA; From the Department of Surgery, Hepatopancreatobiliary Service, and., Pulvirenti A; From the Department of Surgery, Hepatopancreatobiliary Service, and., Lawrence SA; From the Department of Surgery, Hepatopancreatobiliary Service, and., Seier K; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, NY., Gonen M; Department of Epidemiology and Biostatistics, Memorial Sloan Kettering, New York, NY., Balachandran VP; From the Department of Surgery, Hepatopancreatobiliary Service, and., Kingham TP; From the Department of Surgery, Hepatopancreatobiliary Service, and., DʼAngelica MI; From the Department of Surgery, Hepatopancreatobiliary Service, and., Drebin JA; From the Department of Surgery, Hepatopancreatobiliary Service, and., Jarnagin WR; From the Department of Surgery, Hepatopancreatobiliary Service, and., Allen PJ; From the Department of Surgery, Hepatopancreatobiliary Service, and.
Jazyk:	angličtina
Zdroj:	Pancreas [Pancreas] 2019 Jul; Vol. 48 (6), pp. 832-836.
DOI:	10.1097/MPA.0000000000001342
Abstrakt:	Objectives: Preoperative determination of the grade of dysplasia in intraductal papillary mucinous neoplasms (IPMNs) is necessary for optimal management. Previous data have suggested that serum neutrophil-to-lymphocyte ratio (NLR) can predict invasive disease in patients with IPMN. Methods: A prospectively maintained database was queried for consecutive patients who underwent resection of IPMN. Exclusion criteria included recent diagnosis of cancer, immunosuppression, and infection or jaundice within 1 month of operation. A complete blood count with differential within 30 days of operation was used to calculate NLR. Results: Within the study period, 446 patients underwent resection for IPMN, and 348 patients (78%) met the inclusion criteria. Low-grade dysplasia was present in 60 patients (17%), 137 patients (39%) had intermediate-grade dysplasia, 76 (22%) had high-grade dysplasia, and 75 (22%) had invasive carcinoma. A higher NLR was associated with invasive carcinoma as compared with noninvasive disease (3.00 vs 2.68, P = 0.039). There was no difference in NLR between patients with high-risk (invasive and high-grade) and low-risk (low-grade and intermediate-grade) lesions (2.80 vs 2.71, P > 0.95). Conclusions: Neutrophil-to-lymphocyte ratio was significantly higher in patients with IPMN-associated invasive carcinoma as compared with patients with noninvasive disease; however, NLR was not helpful in differentiating between high- and low-grade lesions.
Databáze:	MEDLINE
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