Elevated serum neutrophil-lymphocyte ratio is associated with worse long-term survival in patients with HBV-related intrahepatic cholangiocarcinoma undergoing resection

• DOI: 10.3389/fonc.2022.1012246
• Publication Date: 2022-10-17T05:59:18Z
• Authors: Jianwei Liu; Yong Xia; Feng Xue; Caixia Lu; Jie Wang; Chunyan Wang; Yeye Wu; Shilei Bai; Feng Shen; Kui Wang
• Keywords: 0301 basic medicine; 03 medical and health sciences; Oncology; intrahepatic cholangiocarcinoma; liver resection; inflammation markers; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; survival; nlr; RC254-282; 3. Good health

BackgroundThis study aimed to examine the influence of serum inflammatory marker levels on long-term outcomes after liver resection in patients with intrahepatic cholangiocarcinoma (ICC).MethodsData from 1189 consecutive ICC patients who underwent liver resection were reviewed. The serum neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and prognostic nutritional index (PNI) were measured before surgery. Overall survival (OS) and tumour recurrence were analysed using the Kaplan–Meier method and compared using the log-rank test. Independent risk factors for OS and tumour recurrence were analysed using the Cox hazard regression model.ResultsWe identified elevated serum NLR (≥ 2.15) as an independent risk factor for both OS and tumour recurrence (hazard ratio [HR]: 1.327, 95% confidence interval [CI]: 1.105-1.593; HR: 1.274, 95% CI: 1.074-1.510) among the three inflammatory markers assessed. Elevated NLR was associated with higher carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) levels, larger tumour size, multiple tumours, lymph node metastasis, vascular invasion, and more advanced tumour node metastasis (TNM) stage (III/IV). Subgroup analysis showed that elevated NLR was an independent risk factor for OS and tumour recurrence in patients with hepatitis B virus (HBV) infection compared with patients without HBV infection (HR: 1.347, 95% CI: 1.073-1.690; HR: 1.386, 95% CI: 1.112-1.726).ConclusionsElevated serum NLR was associated with worse prognosis among ICC patients who underwent liver resection, especially in patients with HBV infection.