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Risk factors and prognostic index model for pancreatic cancer.

Background
Pancreatic cancer is a highly malignant tumor with poor prognosis. Chronic inflammation contributes to the progression of pancreatic cancer. However, few studies have examined the prognostic role of inflammatory markers in this cancer. Our study sought to analyze the prognostic risk factors of and construct a prognostic index (PI) model using inflammatory markers for pancreatic cancer.


Methods
Forty-eight patients diagnosed with pancreatic cancer at our hospital were selected for this retrospective analysis. Data on the general clinical characteristics, tumor-related features, blood index factors, and treatment methods were collected. The Cox proportional-hazards model was used to analyze the factors affecting the prognosis, and the Kaplan-Meier analysis was used to draw the survival curve.


Results
The median overall survival time was 14.5 months, and the 1-, 2-, and 3-year survival rates were 20.83% (10/48), 6.25% (3/48), and 4.17% (2/48), respectively. The univariate analysis showed that tumor grade, vascular invasion, adjacent tissue invasion, lymph node metastasis, tumor-node-metastasis (TNM) stage, the neutrophil-lymphocyte ratio (NLR), the platelet-lymphocyte ratio (PLR), and the lymphocyte-monocyte ratio (LMR) were significantly correlated with the median survival of pancreatic cancer patients (P<0.05). The Cox regression equation showed that tumor grade III-IV (X1), vascular invasion (X2), TNM stage III-IV (X3), a NLR >3.8 (X4), and a PLR >182.1 (X5) were independent risk factors affecting the prognosis of patients with pancreatic cancer (all P<0.05). The prognostic model for pancreatic cancer can be expressed as: PI =3.521X1+4.157X2+1.282X3+2.441X4+6.015X5. Patients with tumor grade I-II, non-vascular invasion, TNM stage I-II, a NLR ≤3.8, and a PLR ≤182.1 exhibited a higher 1-year survival rate. The areas under the receiver operating characteristic (ROC) curves for the NLR >3.8 and the PLR >182.1 were 0.778 and 0.713, respectively.


Conclusions
Tumor grade, vascular invasion, TNM staging, the NLR, and the PLR are independent risk factors affecting the prognosis of pancreatic cancer patients. The NLR and PLR have good clinical value in predicting the survival outcomes of pancreatic cancer patients.