晚期胰导管腺癌（PDAC）通常以mFOLFIRINOX或吉西他滨联合化疗进行治疗。然而，选择更合适的治疗策略的预测和预后因素仍然缺乏。本研究旨在评估化疗如何改变免疫系统参数，以及这些变化是否影响生存结果。我们寻求找到一种易于获得的标志物来帮助选择适当的治疗。符合全身化疗条件的PDAC患者符合本研究的资格。基线和治疗两个月后采集外周血样本，使用流式细胞术测量淋巴细胞亚群。进行临床特征和生存分析相关性研究。总计124名患者参与了本研究，其中70名患者接受mFOLFIRINOX治疗，50名患者接受吉西他滨单药治疗。有4名患者由于快速恶化无法接受治疗。在整体生存分析（OS）中，年龄、东方合作组织肿瘤学小组（ECOG）疾病活动状况、分化程度G3、癌胚抗原（CA）19-9浓度大于100 kU/L、绝对白细胞计数、CD3 + CD8+和CD8 + CD57- T淋巴细胞显示显著影响。自然杀伤细胞CD3-CD56 + CD16+和CD3-CD56 + CD16-以及T调节性CD4 + FOXP3 + 细胞和CD3 + CD56+细胞在治疗过程中发生变化，但这些差异没有影响生存结果。基线时，CD8 + CD57- T淋巴细胞数量对无进展生存期和整体生存期具有明显的独立影响。吉西他滨在基线CD8 + CD57-水平极低患者中表现出更好的生存效果。因此，PDAC患者治疗前测量的循环CD3 + CD8+和CD8 + CD57-细胞可以被视为预后和预测生物标志物。Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.

Advanced pancreatic ductal adenocarcinoma (PDAC) is commonly treated with a chemotherapy combination of mFOLFIRINOX or gemcitabine. However, predictive and prognostic factors for choosing a more appropriate treatment strategy are still lacking. This study aimed to evaluate how chemotherapy changes immune system parameters and whether these changes influence survival outcomes. We sought to identify an easily accessible marker to help choose the appropriate treatment. Patients with PDAC who were suitable for systemic chemotherapy were eligible for the study. Peripheral blood samples were obtained at baseline and after two months of treatment. Lymphocyte subsets were measured using flow cytometry. Correlation with clinical features and survival analyses were performed. In total, 124 patients were enrolled in this study. Seventy patients were treated with mFOLFIRINOX and 50 with gemcitabine monotherapy. Four patients could not be treated because of rapid deterioration. During overall survival analysis (OS), significant factors included age, Eastern Cooperative Oncology Group (ECOG) performance status, differentiation grade G3, carcinoma antigen (CA) 19-9 more than 100 kU/L, absolute white blood cell count, CD3 + CD8+, and CD8 + CD57-T lymphocytes. Natural killer CD3-CD56 + CD16 + and CD3-CD56 + CD16- and T regulatory CD4 + FOXP3 + and CD3 + CD56 + cells differed during treatment, but these differences did not influence the survival results. At baseline, CD8 + CD57- T lymphocyte count demonstrated a clear independent impact on progression-free survival and OS. Gemcitabine showed better survival in patients with extremely low baseline CD8 + CD57- levels. Therefore, circulating CD3 + CD8 + and CD8 + CD57- cells measured before treatment in PDAC may be considered prognostic and predictive biomarkers.Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.