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| Combined preoperative platelet-to-lymphocyte ratio and serum carbohydrate antigen 19–9 level as a prognostic factor in patients with resected pancreatic cancer |
| Teruhisa Sakamoto, Hiroaki Saito ∗, Masataka Amisaki, Naruo Tokuyasu, Soichiro Honjo, Yoshiyuki Fujiwara |
Division of Surgical Oncology, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, 36-1 Nishi-cho, Yonago 683-8504, Japan
∗ Corresponding author.
E-mail address: sai10@tottori-u.ac.jp (H. Saito). |
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Abstract Background: Carbohydrate antigen 19–9 (CA19-9) is the most frequently used tumor marker and serves as a prognostic indicator in patients with pancreatic cancer (PC). The platelet-to-lymphocyte ratio (PLR) is thought to be an inflammation-related serum marker. An elevated PLR represents increased inflammatory status and is associated with poor prognosis in patients with various cancers including PC.
Methods: This study involved 103 patients with a histopathological diagnosis of pancreatic ductal ade- nocarcinoma who underwent pancreatectomy. The patients were assessed to determine the prognostic significance of the combination of the PLR and CA19-9 level.
Results: Based on the receiver operating characteristic analysis results, the patients were divided into PLR High (PLR ≥129.1) and PLR Low (PLR <129.1)groupsand into CA19-9 High (CA19-9 ≥74.0 U/mL) and CA19-9 Low (CA19-9 < 74.0 U/mL) groups. The cumulative 5-year overall survival (OS) and disease-specific survival (DSS) rates significantly differed by both the PLR (PLR High group: 19.5% and 22.9%; PLR Low group: 39.1% and 45.9%) and CA19-9 (CA19-9 High group: 19.1% and 25.6%; CA19-9 Low group: 41.0% and 41.0%). We then divided the patients into Groups A (PLR Low /CA19-9 Low ), B (PLR Low /CA19-9 High or PLR High /CA19-9 Low ), and C (PLR High /CA19-9 High ). The cumulative 5-year OS rates in Groups A, B, and C were 44.0%, 31.9%, and 11.9%, respectively ( P = 0.002). The cumulative 5-year DSS rates in Groups A, B, and C were 47.7%, 36.4%, and 16.8%, respectively ( P = 0.002). Multivariate analysis revealed that the combination of the PLR and CA19-9 was an independent prognostic factor in patients with resected PC.
Conclusions: The combination of the PLR and CA19-9 is useful for predicting the prognosis of patients with resected PC.
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2019, Vol. 18 
