Zeng Di, Wang Shaofeng, Cheng Nansheng, Liu Geng, Li Bei
Department of Hepatobiliary Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Research Center for Hepatobiliary Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Clin Transl Gastroenterol. 2025 Apr 18;16(6):e00845. doi: 10.14309/ctg.0000000000000845. eCollection 2025 Jun 1.
Intrahepatic cholangiocarcinoma (ICC) is a highly malignant tumor, often diagnosed at advanced stages, with recurrence and metastasis significantly affecting survival. The combined prognostic value of biomarkers such as the Systemic Immune-Inflammation Index (SII), Fibrosis-4 (FIB-4), and Prognostic Nutritional Index (PNI) remains underexplored.
A retrospective analysis of 280 patients with ICC who underwent curative resection was performed. The prognostic significance of FIB-4, SII, and PNI for overall survival (OS) and disease-free survival (DFS) was assessed using clinical, pathological, and follow-up data. Statistical analysis included Cox regression and Kaplan-Meier survival curves.
High PNI was significantly associated with better OS ( P = 0.014) and DFS ( P = 0.025). High FIB-4 levels correlated with worse OS ( P = 0.0076) and DFS ( P = 0.023). High SII was strongly associated with poor OS ( P < 0.0001) and DFS ( P = 0.00041). The combination of high SII, low PNI, and high FIB-4 was linked to significantly worse OS (hazard ratios = 2.633, P = 0.002) and DFS (hazard ratios = 2.475, P = 0.004).
Preoperative serum biomarkers, including PNI, FIB-4, and SII, are significant independent prognostic factors for patients with ICC. Their combined use may help refine prognostic assessment and guide personalized treatment strategies.
肝内胆管癌（ICC）是一种高度恶性肿瘤，通常在晚期才被诊断出来，复发和转移对生存率有显著影响。全身免疫炎症指数（SII）、纤维化-4（FIB-4）和预后营养指数（PNI）等生物标志物的联合预后价值仍未得到充分探索。
对280例行根治性切除的ICC患者进行回顾性分析。利用临床、病理和随访数据评估FIB-4、SII和PNI对总生存期（OS）和无病生存期（DFS）的预后意义。统计分析包括Cox回归和Kaplan-Meier生存曲线。
高PNI与较好的OS（P = 0.014）和DFS（P = 0.025）显著相关。高FIB-4水平与较差的OS（P = 0.0076）和DFS（P = 0.023）相关。高SII与较差的OS（P < 0.0001）和DFS（P = 0.00041）密切相关。高SII、低PNI和高FIB-4的组合与显著较差的OS（风险比 = 2.633，P = 0.002）和DFS（风险比 = 2.475，P = 0.004）相关。
术前血清生物标志物，包括PNI、FIB-4和SII，是ICC患者重要的独立预后因素。它们的联合使用可能有助于完善预后评估并指导个性化治疗策略。
