JOCS
Journal of Comprehensive Surgery

The aim of the Comprehensive Surgery is to publish original research articles of the highest scientific and clinical value at the international level in all surgical fields. This journal is indexed by indices that are considered international scientific journal indices (DRJI, ESJI, OAJI, etc.). According to the current Associate Professorship criteria, it is within the scope of International Article 1-d. Each article published in this journal corresponds to 5 points.

eISSN: 2980-0862
Creative Commons CC BY-NC-ND 4.0 International License.
EndNote Style

Online Manuscript System

Index
Original Article
Effect of glucose lymphocyte ratio on prognosis in patients operated with the diagnosis of pancreatic adenocarcinoma
Abstract
Aims: Pancreatic adenocarcinoma is one of the most aggressive cancers, and predicting prognosis and survival clinically is challenging. Prognostic markers, easily accessible and routinely evaluated in diagnostic tests, are frequently seen in the literature for survival prediction. So far, the glucose lymphocyte ratio (GLR) has emerged as an indicator that can assess both metabolic dysregulation and immune response. In this study, the aim was to assess the impact of GLR on prognosis and survival by following patients diagnosed with pancreatic adenocarcinoma who underwent surgery.
Methods: Between January 1, 2016, and April 31, 2021, a totalof 58 patients who underwent Whipple procedure due to pancreatic adenocarcinoma at the Department of General Surgery, Hitit University, were included in the study. Demographic characteristics, tumor features, laboratory results, and survival durations of the patients were collected. GLR was determined as a mortality predictor, and estimated survival times associated with GLR were determined using Kaplan-Meier Survival analysis. The optimal GLR value was determined through ROC analysis.
Results: During the postoperative period, the average follow-up time for patients was 11.39 months, with the longest follow-up time being 48 months. During this period, 43 patients (74.14%) were deceased, while 15 patients (25.86%) survived. The mean age and ASA scores of deceased patients were significantly higher compared to survivors (p<0.001 and p<0.001, respectively). Glucose levels were significantly higher in the mortality group compared to the survival group (p=0.008). GLR was notably higher in the mortality group (p=0.170; p=0.703; p=0.429; and p=0.031). The GLR value that best distinguished the two groups was found to be 94.6387 with 93.3% specificity and 95.8% positive predictive value. Crossing this threshold increased the mortality risk approximately 4.27 times within one year and increased the overall mortality risk by approximately 15 times (p=0.014 and p=0.002). The estimated life expectancy for patients below the threshold value was calculated to be an average of 20.996 months, whereas for patients above the threshold value, this expectation was calculated to be an average of 4.427 months (p<0.001).
Conclusion: We believe that GLR may be helpful in predicting one-year survival and determining overall survival duration in patients undergoing surgery for pancreatic adenocarcinoma.

Keywords : Pancreatic adenocarsinoma, glucose lymphocyte ratio, prognosis, survival

Download Article


1. World Health Organization. Absolute numbers, incidence and Mortality, Both sexes, in 2022. Available from: https://gco.iarc.fr/today/en/dataviz/bars?mode=cancer&amp;group_populations=1&amp;key=total&amp;types=0_1&amp;sort_by=value1
2. Zhang CY, Liu S, Yang M. Clinical diagnosis and management of pancreatic cancer: markers, molecular mechanisms, and treatment options. World J Gastroenterol. 2022;28(48):6827-6845.
3. &Ccedil;aparlar MA, Durhan A, S&uuml;leymanov M, Binarbaşı C, Koşmaz K. Prognostic effect of preoperative inflammatory markers on morbidity and overall survival in pancreatic adenocarsinoma. Niger J Clin Pract. 2023;26(12):1902-1909.
4. Lippi G, Mattiuzzi C. The global burden of pancreatic cancer. Arch Med Sci. 2020;16(4):820-824.
5. Li Y, Liu Z, Zhang Y. Expression and prognostic impact of FZDs in pancreatic adenocarcinoma. BMC Gastroenterol. 2021;21(1):79.
6. Zhang Z, Sun W, Zeng Z, Lu Y. Identification of significant prognostic risk markers for pancreatic ductal adenocarcinoma: a bioinformatic analysis. Acta Biochim Pol. 2022;69(2):327-333.
7. Basoglu T, Babacan NA, Ozturk FE, et al. Prognostic value of Gustave Roussy immune score in operable pancreatic adenocarcinoma. Indian J Cancer. 2023;60(2):179-184.
8. Agalianos C, Gouvas N, Manatakis DK, Sideris I, Passas I, Dervenis C. The role of inflammatory markers in predicting resectability of pancreatic ductal adenocarcinoma. Chirurgia (Bucur). 2022;117(4):431-436.
9. Pekarek L, Fraile-Martinez O, Garcia-Montero C, et al. Clinical applications of classical and novel biological markers of pancreatic cancer. Cancers (Basel). 2022;14(8):1866.
10. Liu L, Zhang BB, Li YZ, et al. Preoperative glucose-to-lymphocyte ratio predicts survival in cancer. Front Endocrinol (Lausanne). 2024;15: 1284152.
11. Yılmaz A, Şimşek M, Hannarici Z, B&uuml;y&uuml;kbayram ME, Bilici M, Tekin SB. The importance of the glucose-to-lymphocyte ratio in patients with hepatocellular carcinoma treated with sorafenib. Future Oncol. 2021; 17(33):4545-4559.
12. Yang M, Zhang Q, Ge Y, et al. Glucose to lymphocyte ratio predicts prognoses in patients with colorectal cancer. Asia Pac J Clin Oncol. 2023;19(4):542-548.
13. Hannarici Z, Yılmaz A, Buyukbayram ME, et al. The value of pretreatment glucose-to-lymphocyte ratio for predicting survival of metastatic gastric cancer. Future Oncol. 2023;19(4):315-325.
14. Shadhu K, Xi C. Inflammation and pancreatic cancer: an updated review. Saudi J Gastroenterol. 2019;25(1):3-13.
15. Raghavan SR, Ballehaninna UK, Chamberlain RS. The impact of perioperative blood glucose levels on pancreatic cancer prognosis and surgical outcomes: an evidence-based review. Pancreas. 2013;42(8): 1210-1217.
16. Luo J, Chen YJ, Chang LJ. Fasting blood glucose level and prognosis in non-small cell lung cancer (NSCLC) patients. Lung Cancer. 2012;76(2): 242-247.
17. Huxley R, Ansary-Moghaddam A, Berrington de Gonz&aacute;lez A, Barzi F, Woodward M. Type-II diabetes and pancreatic cancer: a meta-analysis of 36 studies. Br J Cancer. 2005;92(11):2076-2083.
18. Bigot F, Castanon E, Baldini C, et al. Prospective validation of a prognostic score for patients in immunotherapy phase I trials: the Gustave Roussy Immune Score (GRIm-Score). Eur J Cancer. 2017;84: 212-218.
19. Onder AH, İlhan Y, Bal&ccedil;ık OY, Karakaya G. Gustave Roussy imm&uuml;n skor operabl kolorektal kanserli hastalarda prognozu ve sağkalımı &ouml;ng&ouml;rebilir mi? Turkish J Clin Lab. 2023;14(3):496-507.
20. Petrelli F, Barni S, Coinu A, et al. The modified Glasgow Prognostic Score and survival in colorectal cancer: a pooled analysis of the literature. Rev Recent Clin Trials. 2015;10(2):135-141.
21. Imaoka H, Mizuno N, Hara K, et al. Evaluation of modified Glasgow Prognostic Score for pancreatic cancer: a retrospective cohort study. Pancreas. 2016;45(2):211-217.
22. Lebenthal JM, Zheng J, Glare PA, O&rsquo;Reilly EM, Yang AC, Epstein AS. Prognostic value of the Memorial Sloan Kettering Prognostic Score in metastatic pancreatic adenocarcinoma. Cancer. 2021;127(10):1568-1575.
23. Zhong A, Cheng CS, Kai J, Lu R, Guo L. Clinical significance of glucose to lymphocyte ratio (GLR) as a prognostic marker for patients with pancreatic cancer. Front Oncol. 2020;10:520330.
24. Zhang Y, Xu Y, Wang D, et al. Prognostic value of preoperative glucose to lymphocyte ratio in patients with resected pancreatic cancer. Int J Clin Oncol. 2021;26(1):135-144.
Article available in :
Volume 2, Issue 2, 2024
Page : 29-34
https://doi.org/10.51271/JOCS-0030
Article Information
Received : 20 Nis 2024
Accepted : 24 May 2024
Published : 29 May 2024
Corresponding Author :

Ramazan Topçu: Department of General Surgery, Faculty of Medicine, Hitit University, Çorum, Turkiye

[email protected]
Citation : Sezikli İ, Tutan MB, Yüksek MA, Kepez MS, Yıldırım MB, Topçu R. Effect of glucose lymphocyte ratio on prognosis in patients operated with the diagnosis of pancreatic adenocarcinoma. J Compr Surg. 2024;2(2):29-34.

Read: 417
Cited: 0
Download : 142
_Footer