PDF(Pubmed)
Abstract：
BACKGROUND: Intraductal papillary mucinous neoplasm (IPMN) is an important precursor lesion of pancreatic cancer. Systemic inflammatory parameters are widely used in the prognosis prediction of cancer; however, their prognostic implications in IPMN with associated invasive carcinoma (IPMN-INV) are unclear. This study aims to explore the prognostic value of systemic inflammatory parameters in patients with IPMN-INV.
METHODS: From 2015 to 2021, patients with pathologically confirmed IPMN who underwent surgical resection at Peking Union Medical College Hospital were enrolled. The clinical, radiological, and pathological data of the enrolled patients were collected and analyzed. Preoperative systemic inflammatory parameters were calculated as previously reported.
RESULTS: Eighty-six patients with IPMN-INV met the inclusion criteria. The lymphocyte-to-monocyte ratio (LMR) was the only systemic inflammatory parameter independently associated with the cancer-specific survival (CSS). An LMR higher than 3.5 was significantly associated with a favorable CSS in univariate (hazard ratio [HR] 0.305, p = 0.003) and multivariate analyses (HR 0.221, p = 0.001). Other independently prognostic factors included the presence of clinical symptoms, cyst size, N stage, and tumor differentiation. Additionally, a model including LMR was established for the prognosis prediction of IPMN-INV and had a C-index of 0.809.
CONCLUSIONS: Preoperative LMR could serve as a feasible prognostic biomarker for IPMN-INV. A decreased LMR (cutoff value of 3.5) was an independent predictor of poor survival for IPMN-INV.
METHODS: From 2015 to 2021, patients with pathologically confirmed IPMN who underwent surgical resection at Peking Union Medical College Hospital were enrolled. The clinical, radiological, and pathological data of the enrolled patients were collected and analyzed. Preoperative systemic inflammatory parameters were calculated as previously reported.
RESULTS: Eighty-six patients with IPMN-INV met the inclusion criteria. The lymphocyte-to-monocyte ratio (LMR) was the only systemic inflammatory parameter independently associated with the cancer-specific survival (CSS). An LMR higher than 3.5 was significantly associated with a favorable CSS in univariate (hazard ratio [HR] 0.305, p = 0.003) and multivariate analyses (HR 0.221, p = 0.001). Other independently prognostic factors included the presence of clinical symptoms, cyst size, N stage, and tumor differentiation. Additionally, a model including LMR was established for the prognosis prediction of IPMN-INV and had a C-index of 0.809.
CONCLUSIONS: Preoperative LMR could serve as a feasible prognostic biomarker for IPMN-INV. A decreased LMR (cutoff value of 3.5) was an independent predictor of poor survival for IPMN-INV.
摘要：
背景：导管内乳头状黏液性肿瘤（IPMN）是胰腺癌的重要前体病变。全身炎症参数广泛用于癌症的预后预测；然而，其在IPMN相关浸润性癌(IPMN-INV)中的预后意义尚不清楚.本研究旨在探讨全身炎症参数对IPMN-INV患者预后的影响。
方法：选取2015-2021年在北京协和医院行手术切除的经病理证实的IPMN患者。临床，收集并分析入选患者的影像学和病理学资料。术前全身炎症参数如先前报道的那样计算。
结果：86例IPMN-INV患者符合纳入标准。淋巴细胞与单核细胞比率（LMR）是唯一与癌症特异性生存率（CSS）独立相关的全身性炎症参数。在单变量（风险比（HR）0.305，P=0.003）和多变量分析（HR0.221，P=0.001）中，LMR高于3.5与有利的CSS显着相关。其他独立预后因素包括临床症状的存在，囊肿大小,N分期与肿瘤分化程度有关。此外,建立了包含LMR的IPMN-INV预后预测模型,其C指数为0.809.
结论：术前LMR可以作为IPMN-INV的一个可行的预后标志物。LMR降低（临界值为3.5）是IPMN-INV生存不良的独立预测因子。
方法：选取2015-2021年在北京协和医院行手术切除的经病理证实的IPMN患者。临床，收集并分析入选患者的影像学和病理学资料。术前全身炎症参数如先前报道的那样计算。
结果：86例IPMN-INV患者符合纳入标准。淋巴细胞与单核细胞比率（LMR）是唯一与癌症特异性生存率（CSS）独立相关的全身性炎症参数。在单变量（风险比（HR）0.305，P=0.003）和多变量分析（HR0.221，P=0.001）中，LMR高于3.5与有利的CSS显着相关。其他独立预后因素包括临床症状的存在，囊肿大小,N分期与肿瘤分化程度有关。此外,建立了包含LMR的IPMN-INV预后预测模型,其C指数为0.809.
结论：术前LMR可以作为IPMN-INV的一个可行的预后标志物。LMR降低（临界值为3.5）是IPMN-INV生存不良的独立预测因子。
