Investigating Increased Monocyte counts as A Biomarker In Pancreatic Cancer, Exploring Its Link To Tumor-Associated Inflammation

Abstract

Background: Pancreatic cancer remains a highly lethal malignancy with a 5-year survival rate below 12%, driven by late diagnosis and intense desmoplasia. Chronic inflammation is a hallmark of pancreatic carcinogenesis, and circulating monocytes, precursors of tumour-associated macrophages, are key mediators of tumour-promoting inflammation. Their peripheral blood count may reflect tumour burden and inflammatory activity, yet its diagnostic value alongside established inflammatory markers is incompletely defined.

Methodology: We analyzed venous blood samples from 25 pancreatic cancer patients, 25 patients with benign pancreatic disease, and 25 healthy controls. Absolute monocyte count was obtained via complete blood count; serum C-reactive protein (CRP), interleukin-6 (IL-6), and tumour necrosis factor-alpha (TNF-α) were measured as inflammatory indices. Comparisons, correlation analyses, and logistic regression were performed using SPSS v26.

Results & findings: Mean monocyte count was significantly higher in pancreatic cancer patients (0.96 ± 0.14 × 10⁹/L) than in benign disease (0.69 ± 0.11 × 10⁹/L) and healthy controls (0.46 ± 0.08 × 10⁹/L) (p < 0.001). CRP, IL-6, and TNF-α were similarly elevated in the cancer group (p < 0.001). Monocyte counts correlated strongly with CRP (r = 0.73), IL-6 (r = 0.78), and TNF-α (r = 0.71) and rose with advancing tumour stage. In multivariable logistic regression, monocyte count independently predicted pancreatic cancer diagnosis (OR 4.82, p < 0.001).

Conclusion: Peripheral blood monocyte counts are elevated in pancreatic cancer, closely linked to tumour-associated inflammation, and increase with disease severity. As an inexpensive, routinely available parameter, the monocyte count may complement existing diagnostic and prognostic tools. Larger, prospective studies are warranted to validate its clinical utility.