Prognostic significance of neutrophil–lymphocyte ratio in resectable pancreatic neuroendocrine tumors with special reference to tumor-associated macrophages

Autor: Kazuhisa Arakawa, Norihiro Ishii, Takahiro Yamanaka, Takamichi Igarashi, Norio Kubo, Takaharu Fukazawa, Kouki Hoshino, Akira Watanabe, Yasuo Hosouchi, Kei Hagiwara, Kenichirou Araki, Norifumi Harimoto, Mariko Tsukagoshi, Ryo Muranushi, Hayato Ikota, Keitarou Hirai, Ken Shirabe, Hideki Suzuki, Hiroshi Tanaka
Rok vydání: 2019
Předmět:
Adult
Male
medicine.medical_specialty
Neutrophils
Endocrinology
Diabetes and Metabolism
medicine.medical_treatment
Lymphocyte
Kaplan-Meier Estimate
Tumor-associated macrophage
Neuroendocrine tumors
Gastroenterology
Disease-Free Survival
Leukocyte Count
03 medical and health sciences
Pancreatectomy
0302 clinical medicine
Predictive Value of Tests
Internal medicine
White blood cell
medicine
Humans
Lymphocyte Count
Neutrophil to lymphocyte ratio
Aged
Retrospective Studies
Hepatology
business.industry
Macrophages
fungi
Cancer
Middle Aged
Prognosis
medicine.disease
Systemic Inflammatory Response Syndrome
Pancreatic Neoplasms
Neuroendocrine Tumors
Treatment Outcome
medicine.anatomical_structure
Lymphatic system
Lymphatic Metastasis
030220 oncology & carcinogenesis
Female
030211 gastroenterology & hepatology
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: Pancreatology. 19:897-902
ISSN: 1424-3903
Popis: Background Recent studies have shown that the systemic inflammatory response induced by cancer leads to cancer progression. Neutrophil-to-lymphocyte ratio (NLR) is the most reliable marker to detect systemic inflammation. In this study, we investigated the significance of NLR in patients with well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification. Methods We retrospectively collected data for patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at six institutions. Clinicopathological factors, recurrence, and immunohistochemical staining of tumor-associated macrophages (TAMs) were analyzed in a total of 55 patients in this study. Results High NLR (>3.41) in patients was significantly associated with higher white blood cell count, higher Ki-67 index, higher mitotic count, higher grade, higher incidence of lymph node metastasis, higher incidence of lymphatic and neural invasion, massive blood loss, and a large number of CD163-expressing TAMs. Recurrence-free survival of patients with high NLR was significantly poorer than that of patients with low NLR. Multivariate analysis identified high NLR, NET Grade 2 (G2) or Grade 3 (G3), and synchronous hepatic resection as independent risk factors for recurrence after curative resection. Conclusions NLR is a promising predictor of recurrence after pancreatectomy that needs to be further investigated and that accumulation of TAMs in the tumor could be one of the causes of NLR elevation.
Databáze: OpenAIRE
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