Prognostic significance of neutrophil-lymphocyte ratio in resectable pancreatic neuroendocrine tumors with special reference to tumor-associated macrophages.


Journal

Pancreatology : official journal of the International Association of Pancreatology (IAP) ... [et al.]
ISSN: 1424-3911
Titre abrégé: Pancreatology
Pays: Switzerland
ID NLM: 100966936

Informations de publication

Date de publication:
Sep 2019
Historique:
received: 28 02 2019
revised: 06 08 2019
accepted: 07 08 2019
pubmed: 15 8 2019
medline: 25 2 2020
entrez: 15 8 2019
Statut: ppublish

Résumé

Recent studies have shown that the systemic inflammatory response induced by cancer leads to cancer progression. Neutrophil-to-lymphocyte ratio (NLR) is the most reliable marker to detect systemic inflammation. In this study, we investigated the significance of NLR in patients with well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification. We retrospectively collected data for patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at six institutions. Clinicopathological factors, recurrence, and immunohistochemical staining of tumor-associated macrophages (TAMs) were analyzed in a total of 55 patients in this study. High NLR (>3.41) in patients was significantly associated with higher white blood cell count, higher Ki-67 index, higher mitotic count, higher grade, higher incidence of lymph node metastasis, higher incidence of lymphatic and neural invasion, massive blood loss, and a large number of CD163-expressing TAMs. Recurrence-free survival of patients with high NLR was significantly poorer than that of patients with low NLR. Multivariate analysis identified high NLR, NET Grade 2 (G2) or Grade 3 (G3), and synchronous hepatic resection as independent risk factors for recurrence after curative resection. NLR is a promising predictor of recurrence after pancreatectomy that needs to be further investigated and that accumulation of TAMs in the tumor could be one of the causes of NLR elevation.

Sections du résumé

BACKGROUND BACKGROUND
Recent studies have shown that the systemic inflammatory response induced by cancer leads to cancer progression. Neutrophil-to-lymphocyte ratio (NLR) is the most reliable marker to detect systemic inflammation. In this study, we investigated the significance of NLR in patients with well-differentiated pancreatic neuroendocrine tumors (PanNETs) according to the World Health Organization 2017 classification.
METHODS METHODS
We retrospectively collected data for patients with PanNET who underwent pancreatic resection with curative intent between January 2008 and December 2017 at six institutions. Clinicopathological factors, recurrence, and immunohistochemical staining of tumor-associated macrophages (TAMs) were analyzed in a total of 55 patients in this study.
RESULTS RESULTS
High NLR (>3.41) in patients was significantly associated with higher white blood cell count, higher Ki-67 index, higher mitotic count, higher grade, higher incidence of lymph node metastasis, higher incidence of lymphatic and neural invasion, massive blood loss, and a large number of CD163-expressing TAMs. Recurrence-free survival of patients with high NLR was significantly poorer than that of patients with low NLR. Multivariate analysis identified high NLR, NET Grade 2 (G2) or Grade 3 (G3), and synchronous hepatic resection as independent risk factors for recurrence after curative resection.
CONCLUSIONS CONCLUSIONS
NLR is a promising predictor of recurrence after pancreatectomy that needs to be further investigated and that accumulation of TAMs in the tumor could be one of the causes of NLR elevation.

Identifiants

pubmed: 31409525
pii: S1424-3903(19)30684-2
doi: 10.1016/j.pan.2019.08.003
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

897-902

Informations de copyright

Copyright © 2019 IAP and EPC. Published by Elsevier B.V. All rights reserved.

Auteurs

Norifumi Harimoto (N)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan. Electronic address: nharimotoh1@gunma-u.ac.jp.

Kouki Hoshino (K)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Ryo Muranushi (R)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Kei Hagiwara (K)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Takahiro Yamanaka (T)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Norihiro Ishii (N)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Mariko Tsukagoshi (M)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan; Department of Innovative Cancer Immunotherapy, Graduate School of Medicine, Gunma University, Japan.

Takamichi Igarashi (T)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Hiroshi Tanaka (H)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Akira Watanabe (A)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Norio Kubo (N)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Kenichirou Araki (K)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

Yasuo Hosouchi (Y)

Department of Surgery, Gunma Saiseikai Maebashi Hospital, Japan.

Hideki Suzuki (H)

Department of Surgery, Isesaki Municipal Hospital, Japan.

Kazuhisa Arakawa (K)

Department of Surgery, Japanese Red Cross Maebashi Hospital, Japan.

Keitarou Hirai (K)

Department of Gastroenterological Surgery, Takasaki General Medical Center, Japan.

Takaharu Fukazawa (T)

Department of Surgery, Gunma Chuo Hospital, Maebashi, Japan.

Hayato Ikota (H)

Department of Human Pathology, Graduate School of Medicine, Gunma University, Japan.

Ken Shirabe (K)

Department of Hepatobiliary and Pancreatic Surgery, Graduate School of Medicine, Gunma University, Japan.

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