Purpose: Prognostic inflammation-based parameters have been reported as useful tools in various oncologic diseases. Pancreatic ductal adenocarcinoma (PDAC) is characterized by a high mortality rate, making reliable prognostic markers highly desirable. However, there is still inconsistency in the literature regarding the efficacy of the different available scores. Methods: A total of 207 patients, who underwent primary resection of PDAC from January 2000 to December 2018 at the University Hospital of Erlangen, were included in this retrospective single-center study. Different biomarkers, including the preoperative neutrophil–lymphocyte ratio (NLR), the platelet–lymphocyte ratio (PLR), the c-reactive protein (CRP)–albumin ratio (CAR), the lymphocyte–CRP ratio (LCR), the prognostic nutritional index (PNI) and the modified Glasgow prognostic score (mGPS) were analyzed for their ability to predict overall survival (OS). Results: In our cohort, the median overall survival was 20.7 months. Among the investigated biomarkers, NLR and PNI were identified as independent prognostic markers (Hazard Ratio (HR) 1.6 (1.0–2.5),p= 0.048 and HR 0.6 (0.4–0.9),p= 0.018), whereas PLR, CAR, LCR and mGPS did not reach significance in the multivariate analysis. Subgroup analysis revealed that the prognostic value of NLR and PNI is particularly evident in locally advanced tumor stages (pT3/4 and pN+). Conclusions: The NLR and PNI could serve as valuable tools for estimating prognosis in patients with PDAC undergoing pancreatic resection in curative intention, especially in locally advanced tumor stages. However, conflicting results in the current literature highlight the need for further prospective studies to validate these findings.
目的：基于炎症的预后参数已被报道为多种肿瘤疾病的有效评估工具。胰腺导管腺癌（PDAC）具有高死亡率的特点，因此亟需可靠的预后标志物。然而，现有文献中关于不同评分系统效能的结论仍存在不一致。方法：本研究为一项回顾性单中心研究，纳入了2000年1月至2018年12月期间在埃尔朗根大学医院接受PDAC根治性切除术的207例患者。通过分析术前中性粒细胞-淋巴细胞比值（NLR）、血小板-淋巴细胞比值（PLR）、C反应蛋白-白蛋白比值（CAR）、淋巴细胞-C反应蛋白比值（LCR）、预后营养指数（PNI）及改良格拉斯哥预后评分（mGPS）等生物标志物，评估其对总生存期（OS）的预测能力。结果：本队列患者的中位总生存期为20.7个月。在研究的生物标志物中，NLR和PNI被确定为独立的预后标志物（风险比（HR）分别为1.6（1.0–2.5），p=0.048和0.6（0.4–0.9），p=0.018），而PLR、CAR、LCR和mGPS在多变量分析中未达到统计学显著性。亚组分析显示，NLR和PNI的预后价值在局部晚期肿瘤分期（pT3/4和pN+）中尤为显著。结论：NLR和PNI可作为评估接受根治性胰腺切除术的PDAC患者预后的有效工具，尤其适用于局部晚期肿瘤分期患者。然而，当前文献中的矛盾结果凸显了需要进一步开展前瞻性研究以验证这些发现。
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