Neutrophil-to-lymphocyte Ratio as a Predictor of Malignancy of Intraductal Papillary Mucinous Neoplasms

• Published in: Anticancer research Vol. 41; no. 3; pp. 1663 - 1669
• Main Authors: SUGIMACHI, KEISHI, MANO, YOHEI, MATSUMOTO, YOSHIHIRO, NAKANOKO, TOMONORI, UEHARA, HIDEO, NAKASHIMA, YUICHIRO, SUGIYAMA, MASAHIKO, OTA, MITSUHIKO, MORITA, MASARU, TOH, YASUSHI
• Format: Journal Article
• Language: English
• Published: Greece International Institute of Anticancer Research 01.03.2021
• Subjects: Adenocarcinoma; Aged; Biomarkers; Biomarkers, Tumor; Cancer; Carbohydrates; Female; Humans; Invasiveness; Leukocytes (neutrophilic); Lymphocytes; Magnetic resonance imaging; Male; Malignancy; Medical prognosis; Multivariate analysis; Neoplasm Grading; Neoplasms; Neutrophils; Pancreatic Intraductal Neoplasms - immunology; Pancreatic Intraductal Neoplasms - mortality; Pancreatic Intraductal Neoplasms - pathology; Pancreatic Intraductal Neoplasms - surgery; Pancreatic Neoplasms - immunology; Pancreatic Neoplasms - mortality; Pancreatic Neoplasms - pathology; Pancreatic Neoplasms - surgery; Regression analysis; Retrospective Studies; Surgery; Surveillance; Tomography; Tumors; adenocarcinoma; intraductal papillary mucinous neoplasm; surveillance; Neutrophil-to-lymphocyte ratio
• ISSN: 0250-7005; 1791-7530; 1791-7530
• DOI: 10.21873/anticanres.14929

Intraductal papillary mucinous neoplasm (IPMN) can lead, via the adenoma-carcinoma sequence, to invasive adenocarcinoma, which has a poor prognosis. Most IPMNs do not meet the indications for surgery and instead are monitored regularly, but no biomarkers of malignant transformation during surveillance have been established. A total of 50 patients with IPMN who underwent pancreatectomy were evaluated retrospectively. Clinicopathological parameters during the surveillance period before surgery were assessed to explore biomarkers for predicting malignancy. The serum level of carbohydrate antigen 19-9 was significantly higher in IPMN-derived invasive adenocarcinoma. The neutrophil-to-lymphocyte ratio was significantly lower in low-grade IPMN than high-grade and Inv-IPMN cases by univariate and multivariate analysis. Disease-free survival was significantly shorter in patients with high-grade and invasive IPMN compared with those with low-grade IPMN. In patients whose preoperative surveillance was performed for more than 12 months, the neutrophil-to-lymphocyte ratio was significantly higher in those with high-grade and invasive IPMNs compared with patients with low-grade IPMN in the year before surgery. The NLR is a useful biomarker for distinguishing between low-grade and high-grade IPMN and thus should be monitored during surveillance.