P-290 Neutrophil-to-lymphocyte ratio and platelet–lymphocyte ratio as predictive and prognostic markers in patients with pancreatic cancer in Tlemcenian patients

Pancreatic cancer (PC) is one of the most lethal malignant neoplasms in the world. The long-term prognosis of patients with PC is poor, The neutrophil-to-lymphocyte ratio (NLR) and platelet–to-lymphocyte ratio (PLR) are representative blood markers of systemic inflammatory responses. However, the clinical significance of the combination of these markers is unclear. This study aimed to evaluate the impact of NLR and PLR before the start of multimodal treatment on patients with pancreatic cancer and to assess the clinical utility of a new blood score combining the NLR and PLR (NLR-PLR score) as a predictor of tumor response and prognosis. A retrospective study was conducted at the Department of Medical Oncology (CHU Tlemcen), including 114 patients treated for pancreatic cancer before receiving treatment. Complete blood count, NLR, and PLR before initiation of treatment was evaluated and correlated with survival. Value cutoffs were adopted to discriminate patients as follows: low NLR < 3 and high NLR ≥ 3; PLR < 8000 and PLR ≥24000. A total of 114 patients with pancreatic cancer were enrolled in this period of study. NLR and PLR at baseline were available for 82 patients (72%). 32 patients (39 %) with a low NLR < 3 and PLR < 8000 had an average age of 63.6 years [46-89]. 21 of them were men (65 %), and 50% had performance status (PS) 0–1 with 16 cases. Low NLR and PLR were associated with a median survival of 9 months [1-72]. 50 patients (61 %) with a high NLR ≥ 3 and PLR ≥24000 had an average age of 61 years [41-76], with 27 males (54 %), ECOG 0 - I in 22 patients (44 %) and ECOG II-III in 28 cases (56 %). High NLR and PLR were associated with a poor median survival of 2 months [1-7]. Initial NLR > 3 and PLR ≥24000 were associated with shorter survival in patients with pancreatic cancer. The NLR and PLR score can be a useful blood marker to predict therapeutic responses in treatments. In the future, the NLR- PLR scoring system is expected to be useful in decision-making of therapeutic strategies as a key marker in the clinical management of patients with pancreatic cancer. The ratio is a simply accessed and inexpensive but useful biomarker in pancreatic cancer before receiving chemotherapy.