Table_1_Elevated serum neutrophil-lymphocyte ratio is associated with worse long-term survival in patients with HBV-related intrahepatic cholangiocarcinoma undergoing resection.docx

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.

研究背景：本研究旨在探讨血清炎症标志物水平对肝内胆管癌（intrahepatic cholangiocarcinoma, ICC）患者肝切除术后长期预后的影响。
研究方法：本研究回顾性分析了1189例行肝切除术的连续收治肝内胆管癌患者的临床资料。于术前检测患者血清中性粒细胞-淋巴细胞比值（neutrophil-lymphocyte ratio, NLR）、血小板-淋巴细胞比值（platelet-lymphocyte ratio, PLR）以及预后营养指数（prognostic nutritional index, PNI）。采用Kaplan-Meier法分析总生存期（overall survival, OS）与肿瘤复发情况，通过log-rank检验进行组间比较。采用Cox比例风险回归模型分析总生存期与肿瘤复发的独立危险因素。
研究结果：在所评估的三种炎症标志物中，血清中性粒细胞-淋巴细胞比值升高（≥2.15）被证实为总生存期与肿瘤复发的独立危险因素（风险比[hazard ratio, HR]：1.327，95%置信区间[confidence interval, CI]：1.105~1.593；HR：1.274，95% CI：1.074~1.510）。中性粒细胞-淋巴细胞比值升高与更高的碳水化合物抗原19-9（carbohydrate antigen 19-9, CA19-9）、癌胚抗原（carcinoembryonic antigen, CEA）水平、更大的肿瘤体积、多发肿瘤、淋巴结转移、血管侵犯以及更晚的肿瘤-淋巴结-转移（TNM）分期（Ⅲ/Ⅳ期）相关。亚组分析显示，与未感染乙型肝炎病毒（hepatitis B virus, HBV）的患者相比，乙型肝炎病毒感染患者中中性粒细胞-淋巴细胞比值升高是总生存期与肿瘤复发的独立危险因素（HR：1.347，95% CI：1.073~1.690；HR：1.386，95% CI：1.112~1.726）。
研究结论：肝内胆管癌患者行肝切除术后，血清中性粒细胞-淋巴细胞比值升高与不良预后相关，尤其在乙型肝炎病毒感染患者中更为显著。