Department of Surgery, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Department of Pathology and Laboratory Medicine, Tokushima Univercity, 3-18-15 Kuramoto-cho, Tokushima, 770-8503, Japan.
Surg Today. 2021 Dec;51(12):1985-1995. doi: 10.1007/s00595-021-02295-5. Epub 2021 May 19.
To clarify whether the preoperative lymphocyte/C-reactive protein (CRP) ratio (LCR) is a prognostic factor for patients with intrahepatic cholangiocarcinoma (IHCC), and investigate its mechanism via tumor-infiltrating lymphocytes.
The subjects of this retrospective study were 42 patients who had undergone hepatectomy for IHCC. We divided the patients into low LCR and high LCR groups (cutoff value: 8780) and analyzed their overall survival (OS) and disease-free survival (DFS) with respect to LCR and other clinicopathological factors. We also investigated the levels of stromal tumor-infiltrating lymphocytes (TILs) and CD8 TILs in surgical specimens, and the relationship between LCR and TILs.
A low LCR was identified in 21 patients and was significantly correlated with older age, a high CRP-albumin ratio, and advanced disease stage, and was a prognostic factor for OS and DFS. Multivariate analysis revealed that a low LCR was an independent prognostic factor for worse OS (HR 10.40, P = 0.0077). Although the LCR and levels of stromal TILs were not significantly related, LCR and levels of CD8 TILs were significantly related (P = 0.0297).
The preoperative LCR may predict the postsurgical prognosis of patients with IHCC and reflect the CD8 TILs.
明确术前淋巴细胞/ C 反应蛋白(LCR)比值是否为肝内胆管癌(IHCC)患者的预后因素,并通过肿瘤浸润淋巴细胞(TILs)来探讨其机制。
本回顾性研究的对象为 42 例行肝切除术的 IHCC 患者。我们将患者分为低 LCR 组和高 LCR 组(截断值:8780),并根据 LCR 和其他临床病理因素分析其总生存期(OS)和无病生存期(DFS)。我们还检测了手术标本中基质 TILs 和 CD8 TILs 的水平,并研究了 LCR 与 TILs 之间的关系。
21 例患者的 LCR 较低,与年龄较大、CRP-白蛋白比值较高、疾病分期较晚显著相关,是 OS 和 DFS 的预后因素。多因素分析显示,低 LCR 是 OS 较差的独立预后因素(HR 10.40,P = 0.0077)。尽管 LCR 与基质 TILs 水平无显著相关性,但 LCR 与 CD8 TILs 水平显著相关(P = 0.0297)。
术前 LCR 可能预测 IHCC 患者的术后预后,并反映 CD8 TILs。