The Relationship Between Preoperative Serum Inflammatory Markers And Prognosis Of Intrahepatic Cholangiocarcinoma Patients Underwent Hepatectomy

ObjectiveIntrahepatic cholangiocarcinoma(ICC)is the primary hepatic malignant tumor which the morbidity only lower than hepatocellular carcinoma(HCC).Liver resection is the only way to achieve radical treatment.However,the prognosis is disappointing.Therefore,it is necessary to make a further analysis of ICC,especially to explore the prognostic factors of ICC.The aim of this study was to explore the relationship between preoperative serum inflammatory markers and prognosis of ICC patients underwent hepatectomy,and to analyze the role of preoperative serum inflammatory markers in the prognosis of ICC.Methods Data of1312 consecutive ICC patients who underwent liver resection for ICC between 2009 and 2013 at the Eastern Hepatobiliary Surgery Hospital(EHBH)were retrospectively reviewed.A total of 1189 ICC patients were enrolled in this study according to our inclusion and exclusion criteria.The clinical pathological data of these patients was collected and analyzed statistically.The neutrophils-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and prognostic nutritional index(PNI)were measured.The cutoff values of inflammatory markers were determined by the minimum P value method.Firstly,we analyze the prognosis role of inflammatory markers in the whole ICC patients.Secondly,ICC patients were divided into hepatitis B virus(HBV)associated group and non-HBV associated group according to HBV.The prognostic role of inflammatory markers was analyzed in HBV associated ICC group and non HBV associated ICC groups,respectively.Results In the whole population,only NLR ? 2.15 was identified as an independent risk factor of overall survival(OS)and tumor recurrence(hazard ratio [HR]: 1.329,95% confidence interval [CI]: 1.107-1.596;1.271,1.073-1.507)among 3 inflammatory markers.There were 439 patients with NLR<2.15 and 750 patients with NLR ? 2.15.Patients with a NLR of ? 2.15 had higher CA19-9 and CEA levels,larger tumor size,more tumor nodes,more node metastasis and vascular invasion.Subgroup analysis showed that a NLR of ? 2.15 was an independent risk factor of OS and tumor recurrence in the HBV associated ICC group(HR: 1.383,95% CI: 1.043-1.832;1.315,1.021-1.693),but not in the non-HBV associated group.Conclusions Preoperative serum inflammatory marker NLR? 2.15 is an independent risk factor of OS and tumor recurrence in ICC patients,especially for HBVassociated ICC.At the same time,NLR is associated with tumor invasiveness.Patients with NLR? 2.15 had higher CA19-9 and CEA levels,larger tumor size,more tumor nodes,more node metastasis and vascular invasion.