Wu Yunhua, Ren Fenggang, Chai Yichao, Xue Zhao, Shen Cong, Zhang Xufeng, Lv Yi, Hu Liangshuo
Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
Research Institute of Advanced Surgical Techniques and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi 710061, P.R. China.
Oncol Lett. 2019 Jan;17(1):165-174. doi: 10.3892/ol.2018.9618. Epub 2018 Oct 24.
It is widely acknowledged that inflammatory indices may serve as effective prognosis indicators for various malignancies. In the present study, the prognostic value of systemic inflammatory biomarkers for patients undergoing curative resection for intrahepatic cholangiocellular carcinoma (ICC) was investigated. Clinical data of ICC patients who underwent curative resection between September 2008 and July 2017 were collected. Inflammatory indictors were analyzed using the Area Under the Receiver Operating Characteristic Curve. Indictors that were significantly associated with the overall survival (OS) were used to establish a systemic inflammation-based score system and tested via nomogram using R software. The neutrophil To lymphocyte ratio (NLR) and lymphocyte to macrophages ratio (LMR) were significantly associated with the OS and disease-free survival of the patients. High NLR and low LMR were associated with worse clinicopathological and survival outcomes. The univariate and multivariate analyses indicated that tumor T stage, incisal margin, NLR and LMR were associated with the OS of the patients. The systemic inflammation-based scoring system based on LMR and NLR demonstrated a stronger discriminatory capacity and may serve as a useful prognostic parameter for patients undergoing curative resection for ICC. Low LMR and high NLR were observed to be associated with poor prognosis and worse clinical outcomes for patients with ICC undergoing curative surgery. A combined inflammation-based scoring system based on LMR and NLR may effectively predict the outcomes and serve as a novel prognostic predictor for these patients.
炎症指标可作为多种恶性肿瘤的有效预后指标，这一点已得到广泛认可。在本研究中，我们调查了全身炎症生物标志物对接受根治性切除的肝内胆管癌（ICC）患者的预后价值。收集了2008年9月至2017年7月期间接受根治性切除的ICC患者的临床资料。使用受试者操作特征曲线下面积分析炎症指标。将与总生存期（OS）显著相关的指标用于建立基于全身炎症的评分系统，并使用R软件通过列线图进行检验。中性粒细胞与淋巴细胞比值（NLR）和淋巴细胞与巨噬细胞比值（LMR）与患者的OS和无病生存期显著相关。高NLR和低LMR与更差的临床病理和生存结果相关。单因素和多因素分析表明，肿瘤T分期、切缘、NLR和LMR与患者的OS相关。基于LMR和NLR的全身炎症评分系统显示出更强的鉴别能力，可作为接受根治性切除的ICC患者的有用预后参数。对于接受根治性手术的ICC患者，低LMR和高NLR与预后不良和更差的临床结果相关。基于LMR和NLR的联合炎症评分系统可有效预测这些患者的预后，并作为一种新的预后预测指标。
