Inflammatory Biomarkers In Pancreatic Adenocarcinoma And Construction Of Prognostic Models

In recent years,the definition of "precision oncology" has been put forward and widely recognized,but in clinical practice,accurate and practical prognostic biomarkers and models are very few,which to some extent limits the development of diagnosis and treatment in pancreatic adenocarcinoma.Studies have shown that the pathogenesis and progress of pancreatic cancer are correlated with its immune microenvironment and patients’ own immune function.Thus,inflammatory cell infiltration in cancer and immune dysfunction are very common in patients with pancreatic cancer.In this study,I choose inflammatory biomarkers including CRP and albumin,which reflects the systematic inflammation status,as well as COX2 and its regulator Sp1,which reflects local inflammation status.Based on the collection of histological specimens from patients with early pancreatic cancer and serum specimens from advanced pancreatic cancer patients,we investigated inflammatory biomarkers correlated with the prognosis of pancreatic cancer using statistical and bioinformatics tools.We further constructed prognisticmodel based on these biomarkers and compared the differences between these models in accuracy and practicality.In this study,we found that serum C-reactive protein was negatively correlated with albumin.In addition,the CRP to albumin ratio(CAR)was associated with TNM staging,liver metastasis and increasing Aspartate transaminase(AST).Furthermore,CAR could be used as an independent prognostic factor for patients with advanced pancreatic cancer.Based on prognostic biomarkers,we constructed three prognostic models including Among various prognostic models established on the basis of CAR and other independent prognostic factors,the accuracy of nomogram was the highest.In addition,we also found that the transcription factor Sp1 and inflammatory factor cyclooxygenase(COX2),which was regulated by Sp1,were independent factors for pancreatic cancer with early stage.These findings are conducive to clinicians to implement more individualized diagnosis and treatment for pancreatic cancer and offer new ideas to achieve the goal of precision oncology.