Systemic Inflammatory Biomarkers, Especially Fibrinogen to Albumin Ratio, Predict Prognosis in Patients with Pancreatic Cancer.

PURPOSE: Systemic inflammatory response is a critical factor that promotes the initiation and metastasis of malignancies including pancreatic cancer (PC). This study was designed to determine and compare the prognostic value of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and fibrinogen-to-albumin ratio (FAR) in resectable PC and locally advanced or metastatic PC. MATERIALS AND METHODS: Three hundred fifty-three patients with resectable PC and 807 patients with locally advan-ced or metastatic PC were recruited in this study. These patients were classified into a training set (n=758) and a validation set (n=402). Kaplan-Meier survival plots and Cox proportional hazards regression models were used to analyze prognosis. RESULTS: Overall survival (OS) was significantly better for patients with resectable PC with low preoperative PLR (p=0.048) and MLR (p=0.027). Low FAR, MLR, NLR (p < 0.001), and PLR (p=0.003) were significantly associated with decreased risk of death for locally advanced or metastatic PC patients. FAR (hazard ratio [HR], 1.522; 95% confidential interval [CI], 1.261 to 1.837; p < 0.001) and MLR (HR, 1.248; 95% CI, 1.017 to 1.532; p=0.034) were independent prognostic factors for locally advanced or metastatic PC. CONCLUSION: The prognostic roles of FAR, MLR, NLR, and PLR in resectable PC and locally advanced or metastatic PC were different. FAR showed the most prognostic power in locally advanced or metastatic PC. Low FAR was positively correlated with OS in locally advanced or metastatic PC, which could be used to predict the prognosis.

Phospho-STAT5 expression is associated with poor prognosis of human colonic adenocarcinoma.

The signal transducer and activator of transcription-5 (STAT5) protein has been shown to play an important role in tumor progression through stimulating cell proliferation and preventing apoptosis. STAT5 activation has been observed in a variety of human tumors and cancer cell lines. However, it is not clear how activated STAT5 is expressed in colon cancer. In this study, we aimed to investigate phospho-STAT5 (activated form of STAT5) expression and its relationship with the clinicopathological factors and overall survival of patients with colonic adenocarcinoma. A total of 121 histological samples were selected for this study. Immunohistochemistry was used to detect the expression of phospho-STAT5. Analysis of the immunohistochemical staining was based on the proportion of stained cells in the field: positive, >15% stained cells, and negative, <15% stained cells. Survival times were analyzed using the Kaplan-Meier method, and the differences between groups were assessed with the log-rank test. A multivariate Cox regression model was used for prognostic power analysis. Expression of phospho-STAT5 was observed in the cytoplasms of colonic adenocarcinoma cells. Univariate analysis showed that phospho-STAT5 immunoreactivity was correlated with the depth of tumor invasion (P-value = 0.009), tumor-node-metastasis (TNM) stage (P-value = 0.048) and shorter overall survival times (P-value = 0.026). Lymph node metastasis, distant metastasis and TNM stage were associated with shorter overall survival times (P-value range from 0.003- < 0.001). Multivariate analysis showed that only distant metastasis was an independent predictor of overall survival time (P-value = 0.016). Our findings first demonstrate that phospho-STAT5 is frequently present and active in colonic adenocarcinoma and related to poor prognosis.