Comparison of the prognostic values of various inflammation based factors in patients with pancreatic cancer

Med Oncol. 2012 Dec;29(5):3092-100. doi: 10.1007/s12032-012-0226-8. Epub 2012 Apr 5.


The aim of the present study was to determine whether C-reactive protein (CRP)-based systemic inflammatory response scores (modified Glasgow prognostic score, mGPS; prognostic index, PI) have prognostic value superior to that of scores based on circulating white cells (neutrophil/lymphocyte ratio, NLR; platelet/lymphocyte ratio, PLR) or in combination with albumin (prognostic nutritional index, PNI) in patients with pancreatic cancer. The medical records of 177 patients with pancreatic adenocarcinoma were reviewed. Kaplan-Meier methodology and a multivariable Cox proportional hazards model were used to evaluate the potential prognostic factors. NLR > 5 was associated with higher white cell count, higher PLR, elevated CRP, hypoalbuminemia, increased mGPS, PI and PNI, poorer performance status (PS), greater weight loss and poorer tumor differentiation. On multivariate analysis, only NLR (HR, 2.537; 95 % CI, 1.313-4.902; p = 0.006), PS, tumor-node-metastasis (TNM) staging, type of surgery and palliative chemotherapy were associated independently with survival, whereas PLR, mGPS, PI and PNI were not. NLR > 5 predicted poorer overall survival (OS) compared with NLR ≤ 5 (median OS, 4.133 and 9.300, respectively; p = 0.006). On the subgroup analysis, the median OS of patients with NLR > 5 was 5.767 months, whereas patients with NLR ≤ 5 who had received palliative chemotherapy had a median OS of 10.200 months (p < 0.001). Our study demonstrates that elevated NLR is superior to the mGPS, PI, PLR and PNI for prognostication in patients with pancreatic cancer.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / immunology*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / pathology*
  • Aged
  • Blood Platelets / pathology
  • C-Reactive Protein / analysis
  • Female
  • Humans
  • Inflammation
  • Kaplan-Meier Estimate
  • Leukocyte Count*
  • Lymphocytes / pathology
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Neutrophils / pathology
  • Pancreatic Neoplasms / immunology*
  • Pancreatic Neoplasms / mortality
  • Pancreatic Neoplasms / pathology*
  • Prognosis
  • Proportional Hazards Models
  • Tumor Microenvironment / immunology


  • C-Reactive Protein