Neutrophil-lymphocyte ratio predicts survival in pancreatic neuroendocrine tumors

Abstract

Abstract.Although the prognostic role of neutrophil-lymphocyte ratio (NLR) has been confirmed in a variety of tumors, the prognostic role of NLR in pancreatic neuroendocrine tumors (PNETs) has not been examined. The present study was performed to assess the role of NLR as a prognostic factor in patients with PNETs. Clinical data were retrospectively retrieved from a single institution. The best cut-off value for baseline NLR levels was determined by the receiver operating characteristic (ROC) curve and area under the ROC curve. The primary event was overall survival and event times were assessed by the Kaplan-Meier method. Potential factors associated with the elevation of NLR in PNETs were examined. A total of 165 consecutive patients with pathologically confirmed PNETs were included in this study. The cutoff value of NLR was 2.4 by ROC curve (area under ROC curve, 0.70). NLR >2.4 was found to be a poor prognostic factor in the univariate and multivariate analyses. Patients with a NLR value >2.4 had a higher proportion of tumor size at >3 cm (P= 0.001), TNM stage III or IV (P= 0.019), and G2/G3 (P= 0.003). We concluded that NLR is an independent predictor of overall survival for patients with PNETs. Aberrant elevation of NLR identifies high-risk patients with aggressive characteristics.

Prognostic role of lymphocyte-to-monocyte ratio in pancreatic neuroendocrine neoplasms

“…Quite a few studies proved that preoperative systemic inflammation markers, such as neutrophil-to-lymphocyte ratio (NLR) and platelet-tolymphocyte ratio (PLR), were associated with relapse-free survival (RFS) and overall survival (OS) in patients with resected digestive system malignancies, including gastric, colorectal, pancreatic and biliary tract cancers (6,7,8,9). Recently, some research suggested that inflammation markers could play crucial roles in predicting lymph nodes metastasis, liver metastasis and long-term survival in pNEN patients who underwent surgical resections (10,11,12). However, the cut-off points of these markers varied among different reports and no standard critical value has been defined yet.…”

Preoperative neutrophil-to-lymphocyte ratio and tumor-related factors to predict lymph node metastasis in nonfunctioning pancreatic neuroendocrine tumors

“…revealed that NLR was an independent predictor of overall survival for patients with PNETs. However, NLR > 2.4 was not significantly associated with positive lymph status (P = 0.067) 15 . In a retrospective study of 95 patients (21 functional PNETs and 74 NF-PNETs) undergoing resection for PNET, Tong Z et al .…”

“…NLR, which can comprehensively reflect inflammatory and immune status in patients with cancer, has been a reliable marker for predicting the survival of patients with different types of tumor, such as PNET 15 , 16 , lung cancer 17 , colorectal cancer 18 , hepatocellular carcinoma 12 and breast cancer 13 . Interesting, Lee et al .…”

Prognostic Function of Neutrophil-to-Lymphocyte Ratio in Patients with GEP-NEN: A Systematic Review and Meta-Analysis

“…Twenty-one full-text articles were downloaded to assess their eligibility, in which 8 were excluded because non-effective HR data could be collected (n = 2), Conference abstract(n = 17); Data comes from the same sample(n = 2). Ultimately, 13 studies [6][7][8][9][10][11][12][13][14][15][16][17][18] published between 2014 and 2020 were included for this meta-analysis, where the sample sizes ranged from 48 to 259, and the total sample size was 1598. (Fig.…”

“…1) The characteristics of the included studies are summarized in Table 1; among them, 12 studies [6][7][8][9][10][12][13][14][15][16][17][18] are retrospective cohort studies, one [11] is a prospective study. In terms of the research area, seven studies [6,8,[12][13][14][15][16] were performed in China, two [10,18] in Japan, one [9] in Italy, one [7] in the UK, one [18] in Turkey and one [11] in the USA. Regarding tumor site, seven studies concentrated on pancreatic neuroendocrine neoplasm (P-NEN), three studies enrolled patients with gastric neuroendocrine neoplasm (G-NEN), two studies one study enrolled patients with gastrointestinal and pancreatic neuroendocrine neoplasms (GEP-NEN), one study only included enteric neuroendocrine neoplasms (E-NEN).…”