Investigating effects of preoperative inflammatory biomarkers on predicting survival outcomes of intrahepatic cholangioc
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(2020) 18:272
RESEARCH
Open Access
Investigating effects of preoperative inflammatory biomarkers on predicting survival outcomes of intrahepatic cholangiocarcinoma after curative resection Zeyu Zhang, Yufan Zhou, Kuan Hu and Yun Huang*
Abstract Introduction: Intrahepatic cholangiocarcinoma (ICC) stands as the second most common malignant tumor in the liver with poor patient prognosis. Increasing evidences have shown that inflammation plays a significant role in tumor progression, angiogenesis, and metastasis. However, the prognosis significance of inflammatory biomarkers on recurrence-free survival (RFS) and overall survival (OS) in ICC patients is poorly recognized. Methods: ICC patients who underwent curative hepatectomy and diagnosed pathologically were retrospectively analyzed. Inflammatory biomarkers, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII), were investigated. Results: Receiver operating characteristic (ROC) curves showed no significance in NLR, PLR, and LMR in RFS and OS, while significant results were shown on SII in both RFS (P = 0.035) and OS (P = 0.034) with areas under ROC curve as 0.63 (95%CI 0.52–0.74) and 0.62 (95%CI 0.51–0.72), respectively. Kaplan-Meier curves revealed a statistically significant better survival data in SII-low groups on both RFS (P < 0.001) and OS (P < 0.001). The univariate and multivariate analyses revealed that higher level of SII was independently associated with both poorer RFS time and OS time. However, no significant result was shown on NLR, PLR, or LMR. Conclusion: SII is an effective prognostic factor for predicting the prognosis of ICC patient undergone curative hepatectomy, while NLR, PLR, and LMR are not associated with clinical outcomes of these patients. Keywords: Intrahepatic cholangiocarcinoma, Inflammatory biomarker, Systemic immune-inflammation index
Introduction Intrahepatic cholangiocarcinoma (ICC) stands as the second common malignant hepatic neoplasms; however, the incidence of ICC grows worldwide during past decades [1, 2]. Up to now, the best choice of curative treatments is surgical resection, while the treatments for unresectable ICC are very limited [3]. ICC usually grows aggressively without symptom in early stage, resulting in * Correspondence: [email protected] Department of Hepatobiliary Surgery, Xiangya Hospital, Central South University, Changsha, Hunan, China
a small proportion of ICC patients who can receive surgery. Furthermore, the prognosis of resectable ICC patient still remains poor and half of them will suffer from recurrence after surgery [4]. Many researches were performed and found various significant risk factors in ICC, helping the management of ICC patients [5, 6]. Meantime, increasing evidences have shown that inflammation and inflammatory biomarkers are significant factors in tumor microenvironment, thus promoting proliferation, angiogenesis, and metastasis by various inflammatory cells and cytokines
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