系统性炎症评分可用于预测和选择试验患者。我们在晚期胰腺腺癌（PDAC）中比较了5个评分。登记于“为进一步治疗选择广泛分子特征的晚期胰腺导管腺癌综合研究”试验（NCT02750657）的不能手术/转移性PDAC患者被纳入研究。患者接受了治疗前的全基因组和RNA测序生物检测。其中一部分患者提供了CD8免疫组织化学。计算了中性粒细胞/淋巴细胞比值（NLR）、血小板/淋巴细胞比值、预后营养指数、古斯塔夫·鲁西免疫分数（GRIm-S）和Memorial Sloan Kettering预后分数（MPS）。采用Kaplan-Meier方法估计总体生存（OS）。分析了炎症评分、临床/基因特征和OS之间的关联。 我们分析了263名患者。高危的NLR、GRIm-S和MPS预后效果差。GRIm-S的预测能力最高：高风险与低风险相比，中位OS为6.4与10个月（P<0.001）；HR 2.26（P<0.001）。ECOG≥1、基底样亚型和低HRDetect是额外的不良预后因素（P<0.01）。炎症评分与基于RNA的分类器或同源重组修复缺陷基因型没有关联。高风险的MPS（P=0.04）和GRIm-S（P=0.02）患者CD8+肿瘤浸润淋巴细胞的中位数较低。 结论：炎症评分（包括NLR）在晚期PDAC中具有预后价值。了解高风险患者的免疫表型并在试验中使用这些评分将推动该领域的发展。© 2023年。作者（s）独家授权Springer Nature Limited.

Systemic inflammatory scores may aid prognostication and patient selection for trials. We compared five scores in advanced pancreatic adenocarcinoma (PDAC).Unresectable/metastatic PDAC patients enrolled in the Comprehensive Molecular Characterisation of Advanced Pancreatic Ductal Adenocarcinoma for Better Treatment Selection trial (NCT02750657) were included. Patients had pre-treatment biopsies for whole genome and RNA sequencing. CD8 immunohistochemistry was available in a subset. The neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio, Prognostic Nutritional Index, Gustave Roussy Immune Score (GRIm-S), and Memorial Sloan Kettering Prognostic Score (MPS) were calculated. Overall survival (OS) was estimated using Kaplan-Meier methods. Associations between inflammatory scores, clinical/genomic characteristics, and OS were analysed.We analysed 263 patients. High-risk NLR, GRIm-S and MPS were poorly prognostic. The GRIm-S had the highest predictive ability: median OS 6.4 vs. 10 months for high risk vs. low-risk (P < 0.001); HR 2.26 (P < 0.001). ECOG ≥ 1, the basal-like subtype, and low-HRDetect were additional poor prognostic factors (P < 0.01). Inflammatory scores did not associate with RNA-based classifiers or homologous recombination repair deficiency genotypes. High-risk MPS (P = 0.04) and GRIm-S (P = 0.02) patients had lower median CD8 + tumour-infiltrating lymphocytes.Inflammatory scores incorporating NLR have prognostic value in advanced PDAC. Understanding immunophenotypes of poor-risk patients and using these scores in trials will advance the field.© 2023. The Author(s), under exclusive licence to Springer Nature Limited.