尽管胰腺导管腺癌（PDAC）的全身化疗已取得进展，但确保长期生存仍然很困难。关于中性粒细胞与淋巴细胞比值（NLR）在预测PDAC预后方面的作用已有多篇报道，但在全身化疗中的报道很少。我们特此研究 NLR 在 PDAC 全身化疗中的有用性。对接受一线全身化疗的晚期 PDAC 患者进行回顾性研究。采用 Cox 回归风险模型来分析基线患者特征与初始治疗反应和总生存期 (OS) 之间的关联。共有 60 名 PDAC 患者入组。基线时，部分缓解或疾病稳定的患者与疾病进展的患者之间的 NLR 和碳水化合物抗原 19-9 (CA19-9) 以及联合化疗的选择率存在显着差异。单因素和多因素分析显示，NLR < 3.10、联合化疗和CA19-9 < 1011 U/mL是初始治疗反应的显着且独立的预测因素。同时，NLR < 3.10 和联合化疗与更长的 OS 独立相关。此外，无论是联合化疗还是单药治疗，NLR < 3.10 的患者的 OS 均显着延长。基线时 NLR < 3.10 的患者三线化疗转化率显着较高，且总化疗持续时间较长。本研究表明，NLR 可能是预测一线化疗初始治疗反应和预后的有用标志物对于晚期 PDAC 患者。

Although systemic chemotherapy for pancreatic ductal adenocarcinoma (PDAC) has made progress, ensuring long-term survival remains difficult. There are several reports on the usefulness of neutrophil-to-lymphocyte ratio (NLR) in predicting the prognosis of PDAC, but few reports in systemic chemotherapy. We hereby investigated the usefulness of NLR in systemic chemotherapy for PDAC.A retrospective study was conducted on patients with advanced PDAC treated with first-line systemic chemotherapy. Cox regression hazards models were performed to analyze the association between baseline patient characteristics and the initial treatment response, and overall survival (OS).A total of 60 patients with PDAC were enrolled. At baseline, there were significant differences in NLR and carbohydrate antigen 19-9 (CA19-9), as well as the selection rate of combination chemotherapy, between patients with partial response or stable disease and those with progressive disease. Univariate and multivariate analysis showed that NLR < 3.10, combination chemotherapy, and CA19-9 < 1011 U/mL were significant and independent predictive factors of the initial treatment response. Meanwhile, NLR < 3.10 and combination chemotherapy were independently associated with longer OS. Moreover, OS was significantly prolonged in patients with NLR < 3.10, regardless of whether combination chemotherapy or monotherapy. Patients with NLR < 3.10 at baseline had a significantly higher conversion rate to third-line chemotherapy and a longer duration of total chemotherapy.This study suggests that NLR may be a useful marker for predicting the initial treatment response to first-line chemotherapy and the prognosis for patients with advanced PDAC.