Bednarsch Jan, Tan Xiuxiang, Czigany Zoltan, Liu Dong, Lang Sven Arke, Sivakumar Shivan, Kather Jakob Nikolas, Appinger Simone, Rosin Mika, Boroojerdi Shiva, Dahl Edgar, Gaisa Nadine Therese, den Dulk Marcel, Coolsen Mariëlle, Ulmer Tom Florian, Neumann Ulf Peter, Heij Lara Rosaline
Department of Surgery and Transplantation, University Hospital RWTH Aachen, 52074 Aachen, Germany.
NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University, 6211 LK Maastricht, The Netherlands.
Cancers (Basel). 2021 Jul 21;13(15):3661. doi: 10.3390/cancers13153661.
The oncological role of the density of nerve fibers (NFs) in the tumor microenvironment (TME) in intrahepatic cholangiocarcinoma (iCCA) remains to be determined. Therefore, data of 95 iCCA patients who underwent hepatectomy between 2010 and 2019 was analyzed regarding NFs and long-term outcome. Extensive group comparisons were carried out and the association of cancer-specific survival (CSS) and recurrence-free survival (RFS) with NFs were assessed using Cox regression models. Patients with iCCA and NFs showed a median CSS of 51 months (5-year-CSS = 47%) compared to 27 months (5-year-CSS = 21%) in patients without NFs ( = 0.043 log rank). Further, NFs (hazard ratio (HR) = 0.39, = 0.002) and N-category (HR = 2.36, = 0.010) were identified as independent predictors of CSS. Patients with NFs and without nodal metastases displayed a mean CSS of 89 months (5-year-CSS = 62%), while patients without NFs or with nodal metastases but not both showed a median CCS of 27 months (5-year-CSS = 25%) and patients with both positive lymph nodes and without NFs showed a median CCS of 10 months (5-year-CSS = 0%, = 0.001 log rank). NFs in the TME are, therefore, a novel and important prognostic biomarker in iCCA patients. NFs alone and in combination with nodal status is suitable to identify iCCA patients at risk of poor oncological outcomes following curative-intent surgery.
肝内胆管癌（iCCA）肿瘤微环境（TME）中神经纤维（NFs）密度的肿瘤学作用尚待确定。因此，分析了2010年至2019年间接受肝切除术的95例iCCA患者的NFs数据及长期预后情况。进行了广泛的组间比较，并使用Cox回归模型评估癌症特异性生存（CSS）和无复发生存（RFS）与NFs的关联。有NFs的iCCA患者的CSS中位数为51个月（5年CSS = 47%），而无NFs的患者为27个月（5年CSS = 21%）（对数秩检验P = 0.043）。此外，NFs（风险比（HR）= 0.39，P = 0.002）和N分期（HR = 2.36，P = 0.010）被确定为CSS的独立预测因素。有NFs且无淋巴结转移的患者的平均CSS为89个月（5年CSS = 62%），而无NFs或有淋巴结转移但不同时具备这两种情况的患者的CSS中位数为27个月（5年CSS = 25%），同时有阳性淋巴结且无NFs的患者的CSS中位数为10个月（5年CSS = 0%，对数秩检验P = 0.001）。因此，TME中的NFs是iCCA患者一种新的重要预后生物标志物。单独的NFs以及与淋巴结状态相结合，适合于识别根治性手术后患肿瘤学结局不良风险的iCCA患者。
