Increased neutrophil–lymphocyte ratio predicts recurrence in patients with well-differentiated pancreatic neuroendocrine neoplasm based on the 2017 World Health Organization classification

Abstract

Background The prognostic values of inflammation-based markers in well-differentiated pancreatic neuroendocrine neoplasms, diagnosed according to the new 2017 World Health Organization classification, have remained unclear. Therefore, we assessed the ability to predict the recurrence of such markers after curative resection in patients with these neoplasms. Methods Circulating/systemic neutrophil–lymphocyte, monocyte–lymphocyte, platelet–lymphocyte, and platelet–white cell ratios were evaluated in 120 patients who underwent curative resection for well-differentiated pancreatic neuroendocrine neoplasms without synchronous distant metastasis between 2001 and 2018. Recurrence-free-survival and overall survival were compared using Kaplan–Meier analysis and log-rank tests. Univariate or multivariate analyses, using a Cox proportional hazards model, were used to calculate hazard ratios with 95% confidence intervals. Results Univariate analysis demonstrated that preoperative neutrophil–lymphocyte ratio, tumor size, European Neuroendocrine Tumor Society TMN classification, 2017 World Health Organization classification, and venous invasion were associated with recurrence. The optimal preoperative neutrophil–lymphocyte ratio cut-off value was 2.62, based on receiver operating characteristic curve analysis. In multivariate analysis, a higher preoperative neutrophil–lymphocyte ratio (HR = 3.49 95% CI 1.05–11.7; P = 0.042) and 2017 World Health Organization classification (HR = 8.81, 95% CI 1.46–168.2; P = 0.015) were independent recurrence predictors. Conclusions The circulating/systemic neutrophil–lymphocyte ratio is a useful and convenient preoperative prognostic marker of recurrence in patients with well-differentiated pancreatic neuroendocrine neoplasm based on the 2017 World Health Organization classification.

Clinical characteristics, risk factor analysis and peripheral blood cell changes for early warning of multidrug‐resistant bacteria (MDR) infection in elderly patients

“…Recent investigations have corroborated the capacity of NLR and PLR to serve as next‐generation inflammatory markers, reflecting the severity of systemic infections and exhibiting robust correlations with the prognoses of several neoplastic diseases 22–24 . The Miura et al investigation established that, compared to tumor node metastasis classification, increased neutrophil–lymphocyte ratio demonstrated a greater predictive value in the clinical characteristics of malignant tumors 25 …”

“… 22 , 23 , 24 The Miura et al investigation established that, compared to tumor node metastasis classification, increased neutrophil–lymphocyte ratio demonstrated a greater predictive value in the clinical characteristics of malignant tumors. 25 …”

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