Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1, Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Gastroenterological Surgery I, Graduate School of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, 060-8638, Japan.
Surg Today. 2020 Apr;50(4):379-388. doi: 10.1007/s00595-019-01905-7. Epub 2019 Oct 30.
Inflammatory biomarkers such as the neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), and platelet-to-lymphocyte ratio (PLR) are reportedly predictive of the long-term outcomes of several cancers. We evaluated their correlations with the post-surgical long-term outcomes of patients with mass-forming (MF) intrahepatic cholangiocarcinoma (ICC).
The subjects of this study were 52 patients who underwent hepatic resection for MF-ICC at our hospital. We measured the cutoff values of NLR, LMR and PLR, using receiver operating characteristic curves, and compared the survival rates of patients with high vs. those with low values. We also evaluated a prognostic scoring system based on significant inflammatory biomarkers.
The cutoff values for NLR, LMR, and PLR were 1.93, 4.78, and 98, respectively. The high-NLR and low-LMR groups had significantly worse prognoses than the low-NLR and high-LMR groups. We designed a scoring system using the inflammation score (IS) based on NLR and LMR values, stratifying patients into three groups with scores of 0, 1, or 2. The IS was significantly correlated with overall survival (OS), with 5-year survival rates by the IS score of 100% for 0, 61% for 1, and 32% for 2 (P = 0.011). The IS was found to be an independent predictor of OS in multivariate analysis.
Our IS scoring system may predict long-term outcomes after surgery for MF-ICC.
中性粒细胞与淋巴细胞比值（NLR）、淋巴细胞与单核细胞比值（LMR）和血小板与淋巴细胞比值（PLR）等炎症标志物据称可预测多种癌症的长期预后。我们评估了它们与肿块型（MF）肝内胆管细胞癌（ICC）患者术后长期预后的相关性。
本研究的对象是在我院接受肝切除术治疗 MF-ICC 的 52 名患者。我们使用受试者工作特征曲线（ROC）确定 NLR、LMR 和 PLR 的截断值，并比较高值和低值患者的生存率。我们还评估了基于显著炎症生物标志物的预后评分系统。
NLR、LMR 和 PLR 的截断值分别为 1.93、4.78 和 98。高 NLR 和低 LMR 组的预后明显差于低 NLR 和高 LMR 组。我们使用 NLR 和 LMR 值设计了一个炎症评分（IS）评分系统，将患者分为 IS 评分为 0、1 或 2 的三组。IS 与总生存期（OS）显著相关，IS 评分分别为 0、1 和 2 的 5 年生存率为 100%、61%和 32%（P = 0.011）。在多变量分析中，IS 被发现是 OS 的独立预测因子。
我们的 IS 评分系统可能预测 MF-ICC 手术后的长期预后。
