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Objective To explore the factors affecting the prognosis of pancreatic cancer after radical resection for establishing a prognostic prediction model, based on the preoperative neutrophil to lymphocyte ratio (NLR) and prognostic nutritional index (PNI). Methods The clinical data of patients diagnosed with pancreatic ductal adenocarcinoma (PDAC) from January 2013 to December 2019 were retrospectively analyzed. The Kaplan-Meier method was used for survival analysis, the NLR and PNI cut-off values were determined by X-tile software, and the Cox risk ratio model was used to analyze the factors affecting the prognosis of pancreatic cancer. R 4.0.3 software was used to draw a nomogram clinical prediction model of 1, 2, and 3-year survival rates, to evaluate the effectiveness of the prediction model and to establish a web calculator. Results A total of 148 patients were enrolled in the study. The median survival time was 18.2 months. The 1, 2, and 3-year survival rates were 70.8%, 35.8%, and 12.2%,respectively. The cut-off values of NLR and PNI before operation were 1.85 and 44.13, respectively. Combining the two to form NLRP score: 0, 1, and 2. The higher the score, the worse the prognosis (P<0.05). Cox multivariate analysis suggests age >65 years old, high N stage, high TNM stage, no postoperative chemotherapy, postoperative pancreatic fistula and high NLRP score were independent factors affecting the prognosis of pancreatic cancer (P<0.05). The internal verification consistency index (C-index) of the prediction model was 0.710, the calibration curve fitted well, the decision curve showed that the nomogram had a wider clinical net benefit, and the web calculator worked well. Conclusions The NLRP score combined with NLR and PNI can be considered as a new independent prognostic biomarker after radical resection of PDAC. By incorporating the NLRP score into the nomogram, a more accurate and advanced predictive model will be obtained, and the web calculator will be more convenient for doctors and patients to use.
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| 科 Family | 属数 Number of genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) | 属 Genus | 种数 Number of species | 占总种数比例 Percentage of total species (%) |
|---|---|---|---|---|---|---|
| 鹅膏菌科Amanitaceae | 2 | 11 | 5.26 | 鹅膏菌属 Amanita | 10 | 4.78 |
| 小菇科 Mycenaceae | 2 | 12 | 5.74 | 丝盖伞属 Inocybe | 5 | 2.39 |
| 多孔菌科 Polyporaceae | 8 | 14 | 6.70 | 蜡蘑属 Laccaria | 5 | 2.39 |
| 红菇科 Russulaceae | 3 | 23 | 11.00 | 小皮伞属 Marasmius | 6 | 2.87 |
| 小菇属 Mycena | 11 | 5.26 | ||||
| 光柄菇属 Pluteus | 5 | 2.39 | ||||
| 红菇属 Russula | 17 | 8.13 | ||||
| 栓菌属 Trametes | 5 | 2.39 |
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