Copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 28, 2020; 26(8): 828-838
Published online Feb 28, 2020. doi: 10.3748/wjg.v26.i8.828
Haemoglobin, albumin, lymphocyte and platelet predicts postoperative survival in pancreatic cancer
Shuai-Shuai Xu, Shuo Li, Hua-Xiang Xu, Hao Li, Chun-Tao Wu, Wen-Quan Wang, He-Li Gao, Wang Jiang, Wu-Hu Zhang, Tian-Jiao Li, Quan-Xing Ni, Liang Liu, Xian-Jun Yu
Shuai-Shuai Xu, Shuo Li, Hua-Xiang Xu, Hao Li, Chun-Tao Wu, Wen-Quan Wang, He-Li Gao, Wang Jiang, Wu-Hu Zhang, Tian-Jiao Li, Quan-Xing Ni, Liang Liu, Xian-Jun Yu, Department of Pancreatic Surgery, Fudan University, Shanghai Cancer Center, Shanghai 20032, China
Shuai-Shuai Xu, Shuo Li, Hua-Xiang Xu, Hao Li, Chun-Tao Wu, Wen-Quan Wang, He-Li Gao, Wang Jiang, Wu-Hu Zhang, Tian-Jiao Li, Quan-Xing Ni, Liang Liu, Xian-Jun Yu, Pancreatic Cancer Institute, Fudan University, Shanghai 200032, China
Shuai-Shuai Xu, Shuo Li, Hua-Xiang Xu, Hao Li, Chun-Tao Wu, Wen-Quan Wang, He-Li Gao, Wang Jiang, Wu-Hu Zhang, Tian-Jiao Li, Quan-Xing Ni, Liang Liu, Xian-Jun Yu, Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, China
Author contributions: Xu SS, and Li S contributed equally to this work, in conducting clinical observations, analysing the data, and writing the manuscript; Xu SS, Li S, Xu HX, Li H, Wu CT, Wang WQ, Jiang W, Gao HL, Zhang WH, Li TJ, and Ni QX performed the research; Xu HX, Liu L, and Yu XJ contributed equally to this work, in designing the research, revising the manuscript, and providing valuable suggestions for this study.
Supported by the National Science Foundation for Distinguished Young Scholars of China, No. 81625016; the National Natural Science Foundation of Shanghai, No. 19ZR1410800; the National Natural Science Foundation of China, No. 81872366, No. 81871941, No. 81827807, No. 81802675, and No. 81702341; the Outstanding Academic Leader Program of the “ Technological Innovation Action Plan” of the Shanghai Science and Technology Commission, No. 18XD1401200; and the Young Talented Specialist Training Program of Shanghai.
Institutional review board statement: This study was reviewed and approved by the Human Research Ethics Committee of Fudan University Shanghai Cancer Center.
Informed consent statement: Written informed consent has been acquired from each patient.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Xian-Jun Yu, MD, PhD, Professor, Department of Pancreatic Surgery, Pancreatic Cancer Institute, Fudan University Shanghai Cancer Center, 270 Dong’an Road, Shanghai 200032, China. yuxianjun@fudanpci.org
Received: November 23, 2019
Peer-review started: November 23, 2019
First decision: December 23, 2019
Revised: January 8, 2020
Accepted: January 15, 2020
Article in press: January 15, 2020
Published online: February 28, 2020
ARTICLE HIGHLIGHTS
Research background
Systemic inflammation and nutrition status are important factors in cancer metastasis. Hemoglobin, albumin, lymphocyte, and platelet (HALP) consists of haemoglobin, albumin, lymphocytes, and platelets. It is considered the novel marker for both systemic inflammation and nutrition status.
Research motivation
No studies have investigated the relationship between HALP and survival in patients with pancreatic cancer following radical resection.
Research objectives
The study aimed to evaluate the prognostic value of preoperative HALP in pancreatic cancer patients.
Research methods
The relationship between postoperative survival and the preoperative level of HALP was investigated in 582 pancreatic adenocarcinoma patients who underwent radical resection.
Research results
Low levels of HALP were significantly associated with lymph node metastasis (P = 0.002), poor tumor differentiation (P = 0.032), high TNM stage (P = 0.008), female patients (P = 0.005) and tumor location in the head of the pancreas (P < 0.001). Low levels of HALP were associated with early recurrence [7.3 mo vs 16.3 mo, P < 0.001 for recurrence-free survival] and short survival [11.5 mo vs 23.6 mo, P < 0.001 for overall survival] for resected pancreatic adenocarcinoma. A low level of HALP was an independent risk factor for early recurrence and short survival irrespective of sex and tumor location.
Research conclusions
Low levels of HALP could serve as a significant risk factor for recurrence-free survival and overall survival in patients with resected pancreatic cancer.
Research perspectives
The measurement of HALP is necessary for the prediction of disease recurrence and survival in patients with resected pancreatic cancer.
