Wang Zhuo-Ran, Zhang Cun-Zhen, Ding Zhan, Li Yi-Zhuo, Yin Jian-Hua, Li Nan
Department of Hepatic Surgery I (Ward I) Shanghai Eastern Hepatobiliary Surgery Hospital, Navy Medical University, Shanghai 200433, China.
Key Laboratory of Biological Defense, Ministry of Education, Navy Medical University, Shanghai 200433, China.
World J Gastrointest Oncol. 2024 Oct 15;16(10):4092-4103. doi: 10.4251/wjgo.v16.i10.4092.
Intrahepatic cholangiocarcinoma (ICC) is a malignant liver tumor that is challenging to treat and manage and current prognostic models for the disease are inefficient or ineffective. Tumor-associated immune cells are critical for tumor development and progression. The main goal of this study was to establish models based on tumor-associated immune cells for predicting the overall survival of patients undergoing surgery for ICC.
To establish 1-year and 3-year prognostic models for ICC after surgical resection.
Immunohistochemical staining was performed for CD4, CD8, CD20, pan-cytokeratin (CK), and CD68 in tumors and paired adjacent tissues from 141 patients with ICC who underwent curative surgery. Selection of variables was based on regression diagnostic procedures and goodness-of-fit tests (PH assumption). Clinical parameters and pathological diagnoses, combined with the distribution of immune cells in tumors and paired adjacent tissues, were utilized to establish 1- and 3-year prognostic models.
This is an important application of immune cells in the tumor microenvironment. CD4, CD8, CD20, and CK were included in the establishment of our prognostic model by stepwise selection, whereas CD68 was not significantly associated with the prognosis of ICC. By integrating clinical data associated with ICC, distinct prognostic models were derived for 1- and 3-year survival outcomes using variable selection. The 1-year prediction model yielded a C-index of 0.76 95% confidence interval (95%CI): 0.65-0.87 and the 3-year prediction model produced a C-index of 0.69 (95%CI: 0.65-0.73). Internal validation yielded a C-index of 0.761 (95%CI: 0.669-0.853) for the 1-year model and 0.693 (95%CI: 0.642-0.744) for the 3-year model.
We developed Cox regression models for 1-year and 3-year survival predictions of patients with ICC who underwent resection, which has positive implications for establishing a more comprehensive prognostic model for ICC based on tumor immune microenvironment and immune cell changes in the future.
肝内胆管癌（ICC）是一种恶性肝脏肿瘤，治疗和管理具有挑战性，目前该疾病的预后模型效率低下或效果不佳。肿瘤相关免疫细胞对肿瘤的发生和发展至关重要。本研究的主要目的是建立基于肿瘤相关免疫细胞的模型，以预测接受ICC手术患者的总生存期。
建立ICC手术切除后的1年和3年预后模型。
对141例行根治性手术的ICC患者的肿瘤及配对的相邻组织进行CD4、CD8、CD20、全细胞角蛋白（CK）和CD68的免疫组织化学染色。变量选择基于回归诊断程序和拟合优度检验（PH假设）。结合临床参数和病理诊断，以及肿瘤和配对相邻组织中免疫细胞的分布，建立1年和3年预后模型。
这是免疫细胞在肿瘤微环境中的重要应用。通过逐步选择，CD4、CD8、CD20和CK被纳入我们的预后模型建立中，而CD68与ICC的预后无显著相关性。通过整合与ICC相关的临床数据，使用变量选择得出了用于1年和3年生存结局的不同预后模型。1年预测模型的C指数为0.76（95%置信区间[95%CI]：0.65 - 0.87），3年预测模型的C指数为0.69（95%CI：0.65 - 0.73）。内部验证得出1年模型的C指数为0.761（95%CI：0.669 - 0.853），3年模型的C指数为0.693（95%CI：0.642 - 0.744）。
我们开发了Cox回归模型，用于预测接受切除的ICC患者的1年和3年生存率，这对未来基于肿瘤免疫微环境和免疫细胞变化建立更全面的ICC预后模型具有积极意义。
