Tsunematsu Masashi, Haruki Koichiro, Taniai Tomohiko, Tanji Yoshiaki, Shirai Yoshihiro, Furukawa Kenei, Uwagawa Tadashi, Onda Shinji, Yanagaki Mitsuru, Usuba Teruyuki, Nakabayashi Yukio, Okamoto Tomoyoshi, Ikegami Toru
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery The Jikei University School of Medicine Tokyo Japan.
Department of Surgery The Jikei University Katsushika Medical Center Tokyo Japan.
Ann Gastroenterol Surg. 2022 Nov 18;7(3):503-511. doi: 10.1002/ags3.12637. eCollection 2023 May.
The C-reactive protein (CRP)-albumin-lymphocyte (CALLY) index is a novel inflammation-based biomarker, which has been associated with long-term outcomes in patients with hepatocellular carcinoma. We aimed to investigate whether the CALLY index can predict the prognosis for distal cholangiocarcinoma after pancreaticoduodenectomy.
The study comprised 143 patients who had undergone primary pancreaticoduodenectomy for distal cholangiocarcinoma between 2002 to 2019. The CALLY index was defined as (albumin × lymphocyte)/ (CRP × 10). We investigated the association of CALLY index with disease-free survival and overall survival by univariate and multivariate analyses.
Eighty-seven (61%) patients had a preoperative CALLY index <3.5. In multivariate analysis, obstructive jaundice drainage ( < .01), poorly differentiated tumor ( < .01), and CALLY index<3.5 ( = .02) were independent predictors of disease-free survival, while obstructive jaundice drainage ( < .01), poorly differentiated tumor ( < .01), and CALLY index <3.5 ( = .02) were independent predictors of overall survival.
The CALLY index may be an independent and significant indicator of poor long-term outcomes in patients with distal cholangiocarcinoma after pancreaticoduodenectomy, suggesting the importance of comprehensive assessment for inflammatory status.
C反应蛋白（CRP）-白蛋白-淋巴细胞（CALLY）指数是一种基于炎症的新型生物标志物，已被证明与肝细胞癌患者的长期预后相关。我们旨在研究CALLY指数能否预测胰十二指肠切除术后远端胆管癌的预后。
本研究纳入了2002年至2019年间因远端胆管癌接受初次胰十二指肠切除术的143例患者。CALLY指数定义为（白蛋白×淋巴细胞）/（CRP×10）。我们通过单因素和多因素分析研究CALLY指数与无病生存期和总生存期的关系。
87例（61%）患者术前CALLY指数<3.5。在多因素分析中，梗阻性黄疸引流（<0.01）、低分化肿瘤（<0.01）和CALLY指数<3.5（=0.02）是无病生存期的独立预测因素，而梗阻性黄疸引流（<0.01）、低分化肿瘤（<0.01）和CALLY指数<3.5（=0.02）是总生存期的独立预测因素。
CALLY指数可能是胰十二指肠切除术后远端胆管癌患者长期预后不良的独立且重要指标，提示对炎症状态进行综合评估的重要性。
