Table 1 Baseline characteristics of patients with PHC
Variable
|
Total
|
Low-SII(n=78)
|
High-SII(n=86)
|
p value
|
Age, mean (SD), y
|
63.8(10.6)
|
63.6(10.0)
|
64.0(11.2)
|
0.81
|
Sex (n/%)
|
|
|
|
0.09
|
Male
|
91(55.5)
|
38(48.7)
|
53(61.6)
|
|
Female
|
73(44.5)
|
40(51.3)
|
33(38.4)
|
|
Symptom(n/%)
|
|
|
|
0.08
|
Asymptomatic
|
10(6.1)
|
7(9.0)
|
3(3.5)
|
|
Abdominal pain
|
60(36.6)
|
34(43.6)
|
26(30.2)
|
|
Jaundice
|
89(54.3)
|
32(41.0)
|
57(66.3)
|
|
Gastrointestinal symptom
|
5(3.0)
|
5(6.4)
|
0(0.0)
|
|
Cerebrovascular diseases (n/%)
|
66(40.2)
|
31(39.7)
|
35(40.7)
|
0.92
|
Smoking (n/%)
|
48(29.3)
|
20(25.6)
|
28(32.6)
|
0.33
|
Diabetes (n/%)
|
45(27.4)
|
22(28.2)
|
23(26.7)
|
0.84
|
Hepatitis (n/%)
|
3(1.8)
|
2(2.6)
|
1(1.2)
|
0.51
|
WBC, mean (SD), 109/L
|
6.1(1.9)
|
5.3(1.4)
|
6.9(2.1)
|
<0.01
|
Neut, mean (SD), 109/L
|
3.9(1.5)
|
3.1(1.0)
|
4.8(1.4)
|
<0.01
|
Lym, mean (SD), 109/L
|
1.5(0.5)
|
1.6(0.6)
|
1.3(0.4)
|
<0.01
|
PLT, mean (SD), 109/L
|
232.1(83.2)
|
190.9(55.1)
|
269.5(86.9)
|
<0.01
|
HGB, mean (SD), g/L
|
119.1(19.1)
|
121.9(11.2)
|
116.5(21.0)
|
0.07
|
ALB, mean (SD), g/L
|
35.4(4.9)
|
36.0(5.3)
|
34.8(4.5)
|
0.11
|
AST, mean (SD), U/L
|
47.5(96.8)
|
47.0(105.5)
|
52.5(90.7)
|
0.98
|
ALT, mean (SD), U/L
|
64(118.3)
|
60(120.5)
|
73.0(122.3)
|
0.85
|
GGT, mean (SD), U/L
|
288.0(616.5)
|
220.5(651.3)
|
292.5(501.5)
|
0.78
|
DB, mean (SD), μmol/L
|
61.5(124.8)
|
28.1(92.1)
|
73.2(128.0)
|
0.01
|
CEA,median (IQR), U/mL
|
2.5(3.0)
|
2.5(3.1)
|
2.5(2.8)
|
0.47
|
CA199, median (IQR), U/mL
|
66.5(278.5)
|
48.9(146.3)
|
135.4(881.0)
|
0.15
|
PAR, mean (SD)
|
6.7(2.6)
|
5.3(1.7)
|
7.1(2.7)
|
<0.01
|
PNI, mean (SD)
|
42.8(5.9)
|
43.9(6.3)
|
40.7(5.4)
|
<0.01
|
NLR, mean (SD)
|
3.1(2.3)
|
2.0(0.7)
|
3.6(2.8)
|
<0.01
|
OP procedure (n/%)
|
|
|
|
0.66
|
PD (n/%)
|
85(51.8)
|
39(50.0)
|
46(53.5)
|
|
PD with allogeneic venous replacement
|
79(48.2)
|
39(50.0)
|
40(46.5)
|
|
Blood loss, median (IQR), mL
|
500(400)
|
500(400)
|
550(400)
|
0.20
|
OP time, mean (SD), h
|
10.1(2.3)
|
9.9(1.9)
|
10.6(2.8)
|
0.99
|
T-stage (n/%)
|
|
|
|
0.78
|
I
|
31(18.9)
|
18(23.1)
|
13(15.1)
|
|
II
|
46(28.0)
|
19(24.4)
|
27(31.4)
|
|
III
|
8(5.0)
|
2(2.6)
|
6(7.0)
|
|
IV
|
79(48.1)
|
39(50)
|
40(46.5)
|
|
N (n/%)
|
|
|
|
0.83
|
0
|
58
|
28(35.9)
|
30(34.9)
|
|
1
|
65
|
29(37.2)
|
36(41.9)
|
|
2
|
41
|
21(26.9)
|
20(23.3)
|
|
TNM stage (n/%)
|
|
|
|
0.72
|
I
|
29(17.7)
|
15(19.2)
|
14(16.3)
|
|
II
|
37(22.6)
|
17(21.8)
|
20(23.3)
|
|
III
|
98(59.7)
|
46(59)
|
52(60.5)
|
|
IV
|
0(0.0)
|
0(0.0)
|
0(0.0)
|
|
Grading of cancer (n/%)
|
|
|
|
0.63
|
Low
|
47(28.7)
|
16(20.5)
|
31(36.0)
|
|
Intermediate
|
103(62.8)
|
56(71.8)
|
47(54.7)
|
|
High
|
14(8.5)
|
6(7.7)
|
8(9.3)
|
|
Abbreviations: PHC, pancreatic head carcinoma; SD, standard deviation; WBC, white blood cell; PLT, platelet; Neut, neutrophil; HGB, hemoglobin; ALB, albumin; AST, aspartic transaminase; ALT, alanine aminotransferase; DB, direct bilirubin; GGT, gamma-glutamyl transferase; CEA, carcinoembryonic antigen; CA199, carbohydrate antigen 199; PAR, platelet to albumin ratio; PNI, prognostic Nutritional Index; NLR, neutrophil to lymphocyte ratio; IQR, interquartile range; OP, operation; PD, pancreaticoduodenectomy.
Table 2 Factors associated with the total OS in the total cohort
Variable
|
Univariate analysis
|
Multivariate analysis
|
HR (95% CI)
|
p value
|
HR (95% CI)
|
p value
|
PAR
|
1.039 (0.968-1.115)
|
0.290
|
|
|
PNI
|
0.958 (0.928-0.989)
|
0.008
|
0.969(0.937-1.001)
|
0.059
|
NLR
|
1.202 (1.126-1.283)
|
0.000
|
1.135(1.046-1.232)
|
0.002
|
TNM(S1~2 vs S3)
|
1.752 (1.196-2.569)
|
0.004
|
1.803(1.221-2.662)
|
0.003
|
SII (Low vs High)
|
1.837 (1.270-2.656)
|
0.001
|
1.386(0.930-2.065)
|
0.009
|
Abbreviations: PAR, platelet to albumin ratio; PNI, prognostic Nutritional Index; NLR, neutrophil to lymphocyte ratio; TNM S1~2, TNM stage I ~ TNM stage II ; SII, systemic immune-inflammation index SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively.
Table 3 Factors associated with the 1-year OS in the total cohort
Variable
|
Univariate analysis
|
Multivariate analysis
|
HR (95% CI)
|
p value
|
HR (95% CI)
|
p value
|
PAR
|
1.073 (0.982-1.172)
|
0.120
|
0.970(0.866-1.086)
|
0.600
|
PNI
|
0.935 (0.894-0.978)
|
0.003
|
0.947(0.901-0.996)
|
0.033
|
NLR
|
1.204 (1.125-1.288)
|
0.000
|
1.110(1.017-1.213)
|
0.016
|
TNM(S1~2 vs S3)
|
2.382 (1.345-3.103)
|
0.003
|
2.533(1.082-3.905)
|
0.002
|
SII (Low vs High)
|
2.572 (1.503-4.400)
|
0.001
|
2.056(1.082-3.905)
|
0.028
|
Abbreviations: PAR, platelet to albumin ratio; PNI, prognostic Nutritional Index; NLR, neutrophil to lymphocyte ratio; TNM S1~2, TNM stage I ~ TNM stage II ; SII, systemic immune-inflammation index SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively.
Table 4 Factors associated with the DFS in the total cohort
Variable
|
Univariate analysis
|
Multivariate analysis
|
HR (95% CI)
|
p value
|
HR (95% CI)
|
p value
|
PAR
|
1.028 (0.958-1.102)
|
0.147
|
0.971(0.869-1.084)
|
0.597
|
PNI
|
0.968(0.939-0.998)
|
0.038
|
0.945(0.901-0.991)
|
0.021
|
NLR
|
1.213 (1.109-1.327)
|
0.000
|
1.086(0.942-1.252)
|
0.254
|
TNM(S1~2 vs S3)
|
1.657 (1.148-2.393)
|
0.007
|
2.580(1.496-4.450)
|
0.001
|
SII (Low vs High)
|
1.779(1.241-2.550)
|
0.002
|
2.097(1.100-3.998)
|
0.025
|
Abbreviations: PAR, platelet to albumin ratio; PNI, prognostic Nutritional Index; NLR, neutrophil to lymphocyte ratio; TNM S1~2, TNM stage I ~ TNM stage II ; SII, systemic immune-inflammation index SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively.
Table 5 Factors associated with the 1-year DFS in the total cohort
Variable
|
Univariate analysis
|
Multivariate analysis
|
HR (95% CI)
|
p value
|
HR (95% CI)
|
p value
|
PAR
|
1.079 (0.990-1.176)
|
0.083
|
0.960(0.876-1.051)
|
0.376
|
PNI
|
0.938 (0.898-0.979)
|
0.003
|
0.970(0.936-1.005)
|
0.093
|
NLR
|
1.223 (1.111-1.346)
|
0.000
|
1.105(0.963-1.268)
|
0.154
|
TNM(S1~2 vs S3)
|
2.364 (1.378-4.053)
|
0.002
|
1.726(1.185-2.513)
|
0.004
|
SII (Low vs High)
|
2.498(1.491-4.183)
|
0.001
|
1.583(0.977-2.565)
|
0.062
|
Abbreviations: PAR, platelet to albumin ratio; PNI, prognostic Nutritional Index; NLR, neutrophil to lymphocyte ratio; TNM S1~2, TNM stage I ~ TNM stage II ; SII, systemic immune-inflammation index SII = (P × N)/L, where P, N, and L refer to peripheral platelet, neutrophil, and lymphocyte counts, respectively.