Department of General Surgery, Cancer Center, Hepatobiliary & Pancreatic Surgery and Minimally Invasive Surgery, Zhejiang Provincial People's Hospital (Affiliated People's Hospital), Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China.
Department of the Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
BMC Cancer. 2024 Jun 14;24(1):727. doi: 10.1186/s12885-024-12502-4.
The Naples Prognostic Score (NPS), integrating inflammatory and nutritional biomarkers, has been reported to be associated with the prognosis of various malignancies, but there is no report on intrahepatic cholangiocarcinoma (ICC). This study aimed to explore the prognostic value of NPS in patients with ICC.
Patients with ICC after hepatectomy were collected, and divided into three groups. The prognosis factors were determined by Cox regression analysis. Predictive efficacy was evaluated by the time-dependent receiver operating characteristic (ROC) curves.
A total of 174 patients were included (Group 1: 33 (19.0%) patients; Group 2: 83 (47.7%) patients; and Group 3: 58 (33.3%) patients). The baseline characteristics showed the higher the NPS, the higher the proportion of patients with cirrhosis and Child-Pugh B, and more advanced tumors. The Kaplan-Meier curves reflect higher NPS were associated with poor survival. Multivariable analysis showed NPS was an independent risk factor of overall survival (NPS group 2 vs. 1: HR = 1.671, 95% CI: 1.022-3.027, p = 0.009; NPS group 3 vs. 1: HR = 2.208, 95% CI: 1.259-4.780, p = 0.007) and recurrence-free survival (NPS group 2 vs. 1: HR = 1.506, 95% CI: 1.184-3.498, p = 0.010; NPS group 3 vs. 1: HR = 2.141, 95% CI: 2.519-4.087, P = 0.001). The time ROC indicated NPS was superior to other models in predicting prognosis.
NPS is a simple and effective tool for predicting the long-term survival of patients with ICC after hepatectomy. Patients with high NPS require close follow-up, and improving NPS may prolong the survival time.
那不勒斯预后评分（NPS）整合了炎症和营养生物标志物，已被报道与多种恶性肿瘤的预后相关，但尚无关于肝内胆管癌（ICC）的报道。本研究旨在探讨 NPS 在 ICC 患者中的预后价值。
收集接受肝切除术的 ICC 患者，并将其分为三组。通过 Cox 回归分析确定预后因素。通过时间依赖性接受者操作特征（ROC）曲线评估预测效能。
共纳入 174 例患者（组 1：33 例[19.0%]患者；组 2：83 例[47.7%]患者；组 3：58 例[33.3%]患者）。基线特征显示，NPS 越高，肝硬化和 Child-Pugh B 患者的比例越高，肿瘤越晚期。Kaplan-Meier 曲线反映出较高的 NPS 与较差的生存相关。多变量分析表明，NPS 是总生存的独立危险因素（NPS 组 2 与 1 相比：HR=1.671，95%CI：1.022-3.027，p=0.009；NPS 组 3 与 1 相比：HR=2.208，95%CI：1.259-4.780，p=0.007）和无复发生存（NPS 组 2 与 1 相比：HR=1.506，95%CI：1.184-3.498，p=0.010；NPS 组 3 与 1 相比：HR=2.141，95%CI：2.519-4.087，P=0.001）。时间 ROC 表明 NPS 在预测预后方面优于其他模型。
NPS 是预测 ICC 患者肝切除术后长期生存的简单有效工具。NPS 较高的患者需要密切随访，改善 NPS 可能延长生存时间。
