Related Experiment Video
Updated: Jul 14, 2026
Flow Cytometry-Based Isolation and Therapeutic Evaluation of Tumor-Infiltrating Lymphocytes in a Mouse Model of Pancreatic Cancer
Published on: January 17, 2025
The post-neoadjuvant absolute lymphocyte count reflects the pathological response and local tumor control in
Ryo Saito1, Hidetake Amemiya2, Wataru Izumo2
1First Department of Surgery, Faculty of Medicine, University of Yamanashi, 1110 Shimokato, Chuo, Yamanashi, 4093898, Japan. rsaitoh@yamanashi.ac.jp.
Purpose:
Predictive markers of the response to neoadjuvant chemotherapy (NAC) in pancreatic cancer are limited. We investigated whether the absolute lymphocyte count (ALC), a surrogate marker of host immune competence, could predict the pathological response to NAC.
Methods:
This retrospective single-center study included patients with pancreatic ductal adenocarcinoma who underwent pancreatectomy after NAC (2019 and 2025). The pathological response was classified as good (JPS grade ≥ 2) or poor (grade 1a/1b). Logistic regression was used to identify predictors of a good response. Locoregional recurrence was analyzed using competing risk methods.
Results:
Among the 110 patients, 20 (18.2%) achieved a good pathological response. The Preoperative ALC (measured immediately before surgery) was higher in the good-response group (median 1544 vs. 1053/µL, p = 0.014). In a multivariable analysis, ALC independently predicted a good response (OR per 500/µL, 1.59; 95% CI 1.09-2.32; p = 0.016), whereas CA19-9 was not significant. Patients with a good pathological response had a lower cumulative incidence of locoregional recurrence (3-year: 7.0% vs. 37.6%, p = 0.036).
Conclusions:
Preoperative ALC predicts the pathological response to NAC and reflects host immune competence relevant to local tumor control. As a simple and widely available biomarker, ALC may aid in the perioperative decision-making for pancreatic cancer.
