Neutrophil-to-lymphocyte ratio as a predictor of invasive carcinoma in patients with intraductal papillary mucinous neoplasms of the pancreas Journal Article


Authors: McIntyre, C. A.; Pulvirenti, A.; Lawrence, S. A.; Seier, K.; Gonen, M.; Balachandran, V. P.; Kingham, T. P.; D'Angelica, M. I.; Drebin, J. A.; Jarnagin, W. R.; Allen, P. J.
Article Title: Neutrophil-to-lymphocyte ratio as a predictor of invasive carcinoma in patients with intraductal papillary mucinous neoplasms of the pancreas
Abstract: Preoperative determination of the grade of dysplasia in intraductal papillary mucinous neoplasms (IPMNs) is necessary for optimal management. Previous data have suggested that serum neutrophil-to-lymphocyte ratio (NLR) can predict invasive disease in patients with IPMN. Methods A prospectively maintained database was queried for consecutive patients who underwent resection of IPMN. Exclusion criteria included recent diagnosis of cancer, immunosuppression, and infection or jaundice within 1 month of operation. A complete blood count with differential within 30 days of operation was used to calculate NLR. Results Within the study period, 446 patients underwent resection for IPMN, and 348 patients (78%) met the inclusion criteria. Low-grade dysplasia was present in 60 patients (17%), 137 patients (39%) had intermediate-grade dysplasia, 76 (22%) had high-grade dysplasia, and 75 (22%) had invasive carcinoma. A higher NLR was associated with invasive carcinoma as compared with noninvasive disease (3.00 vs 2.68, P = 0.039). There was no difference in NLR between patients with high-risk (invasive and high-grade) and low-risk (low-grade and intermediate-grade) lesions (2.80 vs 2.71, P > 0.95). Conclusions Neutrophil-to-lymphocyte ratio was significantly higher in patients with IPMN-associated invasive carcinoma as compared with patients with noninvasive disease; however, NLR was not helpful in differentiating between high- and low-grade lesions. © 2019 Wolters Kluwer Health, Inc. All rights reserved.
Keywords: intraductal papillary mucinous neoplasm; pancreatic cyst; neutrophil-to-lymphocyte ratio; ipmn-associated carcinoma
Journal Title: Pancreas
Volume: 48
Issue: 6
ISSN: 0885-3177
Publisher: Lippincott Williams & Wilkins  
Date Published: 2019-07-01
Start Page: 832
End Page: 836
Language: English
DOI: 10.1097/mpa.0000000000001342
PUBMED: 31210665
PROVIDER: scopus
DOI/URL:
Notes: Article -- Source: Scopus
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MSK Authors
  1. Mithat Gonen
    729 Gonen
  2. Peter Allen
    455 Allen
  3. William R Jarnagin
    605 Jarnagin
  4. T Peter Kingham
    300 Kingham
  5. Kenneth Seier
    26 Seier
  6. Jeffrey Adam Drebin
    20 Drebin