Different types of cancers may arise from the inflamed regions of the body. It has been widely accepted that inflammation is a key mediator of pancreatic cancer development. Best indicators of systemic immunity include inflammation-associated cell enumeration easily accessible from a complete blood cell (CBC) count. In this study, we investigated changes in potential diagnostic and prognostic biomarkers for cancer: neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), monocyte-lymphocyte-ratio (MLR), derived neutrophil-lymphocyte-ratio (dNLR) and systemic immune-inflammation index (SII) in unresectable pancreatic cancer patients and their correlation with erythrocyte sedimentation rate (ERS). Patients with inoperable pancreatic cancer were retrospectively enrolled in our study. NLR, PLR, MLR, dNLR, SII and ESR were conveyed and analyzed. Statistical analysis was performed using SPSS v.26. Correlations between the variables were determined by Spearman's correlation coefficient. The area under the curve (AUC), sensitivity, specificity, and cut-off values were compared using the receiver operating characteristic (ROC) curve. In patients with inoperable pancreatic cancer, the ESR, NLR, PLR, MLR, dNLR and SII were significantly higher compared with age-matched controls. Data showed no correlation between NLR, PLR, MLR, dNLR, SII and ESR levels. MLR and NLR had the highest AUC scores. For diagnosing unresectable pancreatic cancer the AUC of the ROC curve for NLR was 0.837 with a 95% CI of 0.728-0.946 and for MLR - 0.850 with a 95% CI of 0.746-0.953. However, combining these six markers reached the best specificity and sensitivity (AUC=0.955) in case of unresectable pancreatic cancer.
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