Prognostic value of composite inflammatory prognostic model in pancreatic cancer.

[INTRODUCTION] Pancreatic cancer (PC) remains one of the most lethal malignancies worldwide, creating a critical need for reliable prognostic biomarkers, particularly those reflecting tumor microenvironment dynamics.

[METHODS] We investigated the combined prognostic value of a composite inflammatory prognostic model for PC progression. A retrospective cohort analysis of 171 patients with PC was conducted using receiver operating characteristic (ROC) curve analysis, along with univariate and multivariate Cox regression analyses. Survival curves were plotted using the Kaplan-Meier method. A clinical prognostic nomogram was constructed based on independent prognostic factors.

[RESULTS] ROC curve analysis demonstrated that C-reactive protein-to-lymphocyte ratio (CLR) had the highest predictive accuracy for 3-year survival. Survival analysis revealed that TNM stage, CA19-9, CEA, neutrophil count, CRP level, the neutrophil-to-lymphocyte ratio (NLR), and CLR were significantly associated with overall survival. Multivariate Cox regression analysis confirmed that advanced lymphatic metastasis, advanced TNM stage, elevated CA19-9, elevated CEA, elevated neutrophil count, elevated NLR, and elevated CLR were independent prognostic factors. The prognostic nomogram incorporating these variables exhibited robust discriminative capacity and well-calibrated predictions of survival. Using the inflammatory prognostic model, patients in the high-risk group had a significantly shorter median overall survival than those in the low-risk group, with strong predictive accuracy for 1-year and 3-year survival. Validation in a subgroup of patients with pancreatic ductal adenocarcinoma further supported the clinical utility of the model, showing superior 3-year predictive performance and a pronounced survival disparity between the risk groups.

[CONCLUSIONS] A combination of inflammatory and clinical markers can effectively predict the prognosis of pancreatic cancer. The constructed composite inflammatory prognostic model demonstrated high clinical practical value and provided a reliable tool for individualized prognostic risk assessment.