Neutrophil/lymphocyte ratio is a more sensitive systemic inflammatory response biomarker than platelet/lymphocyte ratio in the prognosis evaluation of unresectable pancreatic cancer

Abstract

// Yuan Gao 1, * , Wen-Jie Wang 1, * , Qiaoming Zhi 2, * , Meng Shen 1 , Min Jiang 1 , Xiaojie Bian 1 , Fei-Ran Gong 3 , Chong Zhou 4 , Lian Lian 1, 5 , Meng-Yao Wu 1 , Jun Feng 1 , Min Tao 1, 6 and Wei Li 1, 6, 7 1 Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China 2 Department of General Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China 3 Department of Hematology, The First Affiliated Hospital of Soochow University, Suzhou, China 4 Department of Radiation Oncology, Xuzhou Central Hospital, Xuzhou, China 5 Department of Oncology, Suzhou Xiangcheng People's Hospital, Suzhou, China 6 PREMED Key Laboratory for Precision Medicine, Soochow University, Suzhou, China 7 Center for Systems Biology, Soochow University, Suzhou, China * These authors have contributed equally to this work Correspondence to: Wei Li, email: liwei10@suda.edu.cn Meng-Yao Wu, email: mywu@suda.edu.cn Jun Feng, email: fengjun2001-260@163.com Keywords: pancreatic cancer, systemic inflammatory response (SIR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) Received: April 21, 2017     Accepted: July 26, 2017     Published: September 27, 2017 ABSTRACT Multiple cancers arise from sites of infection, chronic irritation, and inflammation. It has been widely accepted that pancreatic cancer is an inflammation-driven cancer. In this study, we investigated the application value of systemic inflammatory markers, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR), in the prediction of chemotherapy response and prognosis in patients with late pancreatic cancer. 122 patients with inoperable pancreatic cancers were included and separated into two groups according to median values of NLR or PLR (NLR low:< 3.81 or NLR high:≥3.81, and PLR low:<142.14 or PLR high≥142.14, respectively). Baseline NLR and PLR levels were significantly higher in pancreatic cancer patients compared with the healthy subjects. Neither of the baseline NLR or PLR levels could predict outcomes. Patients with low baseline level of NLR, but not PLR, had better responses to chemotherapy. Changes in NLR, but not PLR levels, were associated with the therapeutic efficacy. Patients who stayed in or dropped into the low NLR level subgroup after first-line chemotherapy had better responses, comparing to those stayed in or jumped into the high NLR level group. No similar results could be observed when the PLR level was investigated. Therefore, NLR is a more sensitive biomarker than PLR in the prediction of chemotherapy response of patients.