A combined carbohydrate antigen 125 and lymphocyte-to-monocyte ratio score stratifies time-window-specific recurrence after pancreatic cancer surgery.
- 1School of Public Health, Zhengzhou University, Zhengzhou, China.
- 2Follow-up Office, Henan Cancer Hospital, Zhengzhou, China.
- 3Scientific Research and Foreign Affairs Office, Henan Provincial People's Hospital, Zhengzhou, China.
Abstract
Background
Early recurrence after pancreatic resection is a major cause of treatment failure in pancreatic cancer. We evaluated whether a score combining carbohydrate antigen 125 (CA125) with the lymphocyte-to-monocyte ratio (LMR) could stratify recurrence risk across clinically relevant time windows.Methods
This retrospective cohort included 1,618 patients who underwent pancreatic cancer surgery. Recurrence within 6, 12, and 24 months was defined as ER6, ER12, and ER24, respectively, with ER12 prespecified as the primary endpoint. ER12-derived cutoffs were 44.760 U/mL for CA125 and 5.764 for LMR; one point was assigned for elevated CA125 and one for low LMR, yielding a 0-2 score. Discrimination was assessed using receiver operating characteristic curves and pairwise DeLong tests, and disease-free survival was evaluated using Kaplan-Meier analysis.Results
ER12 occurred in 779 patients (48.1%). For ER12, the CA125-LMR score yielded an area under the curve (AUC) of 0.742 [95% confidence interval (CI), 0.720-0.764], with 91.4% sensitivity and 44.3% specificity. Its AUC exceeded those of CA125 alone (0.698; p < 0.001) and the CA19-9-LMR score (0.692; p < 0.001), but did not differ significantly from that of LMR alone (0.735; p = 0.463). The score showed AUCs of 0.694 for ER6 and 0.809 for ER24; at 24 months, LMR alone performed better (AUC, 0.835; p = 0.003). Disease-free survival decreased stepwise across scores 0, 1, and 2 (log-rank p < 0.001).Conclusion
The CA125-LMR score is a simple, interpretable tool for recurrence-risk stratification after pancreatic cancer surgery, with its clearest utility in early and intermediate time windows. External validation is required before clinical implementation.
Related
- Tumor-adjacent B cell infiltration stratifies recurrence risk in localized prostate cancer
- Predictive value of combined estimated plasma volume status and neutrophil-to-lymphocyte ratio for cardiovascular mortality in patients with acute myocardial infarction with heart failure
- A Combined ODE Model of Carbohydrate Fermentation and Colorectal Cancer
- Association between preoperative hemoglobin, albumin, lymphocyte, and platelet (HALP) score and stricture recurrence after urethroplasty
- Neutrophil-to-Lymphocyte Ratio as a Prognostic Biomarker in Pancreatic Neuroendocrine Neoplasms
BibTeX
@article{yi2026combined,
title = {{A combined carbohydrate antigen 125 and lymphocyte-to-monocyte ratio score stratifies time-window-specific recurrence after pancreatic cancer surgery.}},
author = {Bin Yi and Xiance Tang and Xuejiao Chen and Qingfeng Tian},
journal = {Frontiers in medicine},
year = {2026},
month = oct,
doi = {10.3389/fmed.2026.1971334},
url = {https://europepmc.org/article/MED/42924252},
note = {CC BY},
}
RIS
TY - JOUR
TI - A combined carbohydrate antigen 125 and lymphocyte-to-monocyte ratio score stratifies time-window-specific recurrence after pancreatic cancer surgery.
AU - Bin Yi
AU - Xiance Tang
AU - Xuejiao Chen
AU - Qingfeng Tian
PY - 2026
DA - 2026/10/08
JO - Frontiers in medicine
DO - 10.3389/fmed.2026.1971334
UR - https://europepmc.org/article/MED/42924252
AB - Background Early recurrence after pancreatic resection is a major cause of treatment failure in pancreatic cancer. We evaluated whether a score combining carbohydrate antigen 125 (CA125) with the lymphocyte-to-monocyte ratio (LMR) could stratify recurrence risk across clinically relevant time windows.Methods This retrospective cohort included 1,618 patients who underwent pancreatic cancer surgery. Recurrence within 6, 12, and 24 months was defined as ER6, ER12, and ER24, respectively, with ER12 prespecified as the primary endpoint. ER12-derived cutoffs were 44.760 U/mL for CA125 and 5.764 for LMR; one point was assigned for elevated CA125 and one for low LMR, yielding a 0-2 score. Discrimination was assessed using receiver operating characteristic curves and pairwise DeLong tests, and disease-free survival was evaluated using Kaplan-Meier analysis.Results ER12 occurred in 779 patients (48.1%). For ER12, the CA125-LMR score yielded an area under the curve (AUC) of 0.742 [95% confidence interval (CI), 0.720-0.764], with 91.4% sensitivity and 44.3% specificity. Its AUC exceeded those of CA125 alone (0.698; p < 0.001) and the CA19-9-LMR score (0.692; p < 0.001), but did not differ significantly from that of LMR alone (0.735; p = 0.463). The score showed AUCs of 0.694 for ER6 and 0.809 for ER24; at 24 months, LMR alone performed better (AUC, 0.835; p = 0.003). Disease-free survival decreased stepwise across scores 0, 1, and 2 (log-rank p < 0.001).Conclusion The CA125-LMR score is a simple, interpretable tool for recurrence-risk stratification after pancreatic cancer surgery, with its clearest utility in early and intermediate time windows. External validation is required before clinical implementation.
SN - 2296-858X
ER -