Background:We retrospectively evaluated the usefulness of an elevated glucose-to-lymphocyte ratio (GLR) as a sensitive prognostic biomarker of disease-specific survival in 338 patients who underwent surgical resection of pancreatic ductal adenocarcinoma (PDAC).Methods:The optimal GLR cutoff value was determined using the method of Contal and O’Quigley. Patient demographics, clinical information, and imaging data were analyzed to identify preoperative predictors of long-term survival outcomes.Results:Elevated GLR correlated significantly with aggressive tumor biologic behaviors, such as a high carbohydrate antigen (CA) 19-9 level (p= 0.003) and large tumor size (p= 0.011). Multivariate analysis identified (1) GLR > 92.72 [hazard ratio (HR) = 2.475,p< 0.001], (2) CA 19-9 level > 145.35 (HR = 1.577,p= 0.068), and (3) symptoms (p= 0.064) as independent predictors of long-term, cancer-specific survival. These three risk factors were used to group patients into groups 1 (0 factors), 2 (1–2 factors), and 3 (3 factors), which corresponded to significantly different 5-year overall survival rates (50.2%, 34.6%, and 11.7%, respectively;p< 0.001).Conclusions:An elevated preoperative GLR is associated with aggressive tumor characteristics and is an independent predictor of poor postoperative prognosis in patients with PDAC. Further prospective studies are required to verify these findings.
背景：本研究回顾性评估了葡萄糖与淋巴细胞比值（GLR）升高作为胰腺导管腺癌（PDAC）患者疾病特异性生存敏感预后标志物的价值，共纳入338例接受手术切除的PDAC患者。 方法：采用Contal和O'Quigley法确定GLR最佳截断值。通过分析患者人口统计学特征、临床资料及影像学数据，确定影响长期生存结局的术前预测因素。 结果：GLR升高与侵袭性肿瘤生物学行为显著相关，包括高碳水化合物抗原（CA）19-9水平（p=0.003）和较大肿瘤体积（p=0.011）。多变量分析显示：（1）GLR > 92.72[风险比（HR）=2.475，p<0.001]；（2）CA 19-9水平 > 145.35（HR=1.577，p=0.068）；（3）临床症状（p=0.064）是影响长期癌症特异性生存的独立预测因子。根据这三个风险因素将患者分为第1组（0个因素）、第2组（1-2个因素）和第3组（3个因素），其5年总生存率存在显著差异（分别为50.2%、34.6%和11.7%，p<0.001）。 结论：术前GLR升高与PDAC患者侵袭性肿瘤特征相关，是术后不良预后的独立预测指标。需开展进一步前瞻性研究验证该结论。
肿瘤(癌症)患者之家