DataSheet1_A Myeloid Signature-Based Nomogram Predicts the Postoperative Recurrence of Intrahepatic Cholangiocarcinoma.pdf

Intrahepatic cholangiocarcinoma (iCCA) is the second most common cancer in liver, with a high recurrence rate after surgery. Recently, we identified a CD11b-CD169-based myeloid response score (MRS), which showed remarkable prognostic potential in hepatocellular carcinoma (HCC). Here, we aimed to verify the prognostic value of the MRS in iCCA and establish an MRS-based nomogram to predict the postoperative prognosis of iCCA patients. From April 2005 to March 2017, a total of 84 patients from the Third Affiliated Hospital of Sun Yat-sen University were enrolled. Preoperative clinical information and surgical specimens of enrolled patients were collected. Among these, tissues from 75 patients passed the clinical data quality control and the staining quality control. The protein expression of CD11b and CD169 in iCCA samples were detected by immunohistochemistry (IHC). Kaplan-Meier analysis and receiver operating characteristic (ROC) curves revealed that the MRS had a high discriminatory ability for predicting the time to recurrence (TTR) of iCCA patients after surgery. Three independent risk factors selected by a Cox proportional hazards regression analysis, namely, the MRS, the tumor size and the status of vascular invasion, were included to construct a nomogram to predict the recurrence of iCCA after resection surgery. ROC curves, calibration analysis and decision curve analysis (DCA) suggested that this nomogram had notable discriminatory power, stability and clinical usefulness in predicting the postoperative recurrence. Together, we explored the prognostic value of the MRS in iCCA, and constructed an MRS-based nomogram which may help to predict postoperative recurrence and aid clinical decisions for iCCA patients.

肝内胆管癌（Intrahepatic cholangiocarcinoma, iCCA）是肝脏第二常见的恶性肿瘤，术后复发率较高。近期本团队确立了基于CD11b-CD169的髓系应答评分（myeloid response score, MRS），该评分在肝细胞癌（hepatocellular carcinoma, HCC）中展现出显著的预后潜力。本研究旨在验证MRS在肝内胆管癌中的预后价值，并构建基于MRS的列线图以预测肝内胆管癌患者的术后预后。

2005年4月至2017年3月，本研究共纳入中山大学附属第三医院的84例患者，收集其术前临床资料与手术标本。其中，75例患者的组织样本通过了临床数据质控与染色质控。采用免疫组化（immunohistochemistry, IHC）法检测肝内胆管癌样本中CD11b与CD169的蛋白表达水平。

Kaplan-Meier分析法与受试者工作特征（receiver operating characteristic, ROC）曲线分析结果显示，MRS对预测肝内胆管癌患者术后复发时间（time to recurrence, TTR）具有较高的区分效能。通过Cox比例风险回归分析筛选出3个独立危险因素：MRS、肿瘤大小及血管浸润状态，据此构建用于预测肝内胆管癌切除术后复发的列线图。ROC曲线、校准分析与决策曲线分析（decision curve analysis, DCA）结果表明，该列线图在预测术后复发方面具有优异的区分效能、稳定性与临床实用性。

综上，本研究明确了MRS在肝内胆管癌中的预后价值，并构建了基于MRS的列线图，该工具可辅助预测肝内胆管癌患者的术后复发风险，助力临床决策制定。