Introduction: Chronic pancreatitis (CP) is a premalignant condition for carcinoma pancreas. Worrisome lesions in CP in pancreatic head warrant pancreatico-duodenectomy because CA19-9/CECT/MRI-MRCP/PET/EUS-FNA often fail to differentiate inflammatory and malignant lesions. Objective of this study was to assess predictive values of NLR, PLR and CA19-9 for malignant CP. Methodology: Single centre retrospective analysis done in Department of Surgical Gastroenterology, Medical College, Trivandrum, Kerala; on CP (Group-1) and carcinoma pancreas (Group-II) from 1/1/2014-31/12/2018. Group-I was stratified as CP-benign (Group-IB) and CP-malignant (Group-IM). From their absolute neutrophil count, lymphocyte count and platelet counts, NLR and PLR values were calculated. ROC analyses done for cut off values with PPV and NPV. Results: 255 patients; enrolled into Group-I (n=113; 75.92% Group-IB and 24.07% Group-IM) and Group-II (n=142). By ROC, sensitivity, specificity, PPV, NPV; and accuracy of Group-I with NLR cut off value of 2.345 were 68.11%/73.72%/59.62/91.80% and with 2.813, were 58.3%/90.2%/72.4%/82.14%. For PLR; with cut off at 138.65 were 63.89%/88.5%/69.7%/83.75%; and with 157.95 were 48.6%/91.8%/70.83%/78.65%. Discussion: By ROC, CA19-9 of 100.21U/ml showed 82.9% sensitivity and 85.2% Specificity for malignant CP. NLR of 2.345 showed 68.11% sensitivity, 73.72% specificity, 59.62 PPV and 91.80% NPV; 2.813 had 58.3% sensitivity, 90.2% specificity, 72.4% PPV and 82.14% NPV. PLR of 138.65 showed 63.89% sensitivity, 88.5% specificity, 69.7% PPV and 83.75% NPV and 157.95 had 48.6% sensitivity, 91.8% specificity, 70.83% PPV and 78.65% NPV. Conclusion: NLR and PLR in CP carcinoma and denovo-DACP were comparable. NLR and PLR have showed significant predictive values, comparing benign and malignant CP.
Sindhu RS, Ramesh Rajan, Antony Stanley, Fahaduzzaman P, Bonny Natesh P. Predictive values of neutrophil lymphocyte ratio and platelet lymphocyte ratio for adenocarcinoma arising in chronic pancreatitis. International Journal of Medicine Research, Volume 5, Issue 3, 2020, Pages 18-25