Preoperative lymphocyte/C-reactive protein ratio and its correlation with CD8+ tumor-infiltrating lymphocytes as a predictor of prognosis after resection of intrahepatic cholangiocarcinoma

• Published in: Surgery today (Tokyo, Japan) Vol. 51; no. 12; pp. 1985 - 1995
• Main Authors: Miyazaki, Katsuki, Morine, Yuji, Imura, Satoru, Ikemoto, Tetsuya, Saito, Yu, Yamada, Shinichiro, Tokuda, Kazunori, Okikawa, Shohei, Yamashita, Shoko, Oya, Takeshi, Tsuneyama, Koichi, Shimada, Mitsuo
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.12.2021
• Subjects: Bile Duct Neoplasms - diagnosis; Bile Duct Neoplasms - immunology; Bile Duct Neoplasms - pathology; Bile Duct Neoplasms - surgery; Biomarkers, Tumor - blood; C-Reactive Protein; CD8-Positive T-Lymphocytes - immunology; CD8-Positive T-Lymphocytes - pathology; Cholangiocarcinoma - diagnosis; Cholangiocarcinoma - immunology; Cholangiocarcinoma - pathology; Cholangiocarcinoma - surgery; Female; Humans; Lymphocyte Count; Lymphocytes, Tumor-Infiltrating - immunology; Lymphocytes, Tumor-Infiltrating - pathology; Male; Medicine; Medicine & Public Health; Original Article; Predictive Value of Tests; Preoperative Period; Prognosis; Surgery; Surgical Oncology; tumor-infiltrating lymphocytes; CD8; Intrahepatic cholangiocarcinoma; Lymphocyte/C-reactive protein ratio; Stromal tumor-infiltrating lymphocytes; CD8+ tumor-infiltrating lymphocytes
• ISSN: 0941-1291; 1436-2813
• DOI: 10.1007/s00595-021-02295-5

Purpose To clarify whether the preoperative lymphocyte/C-reactive protein (CRP) ratio (LCR) is a prognostic factor for patients with intrahepatic cholangiocarcinoma (IHCC), and investigate its mechanism via tumor-infiltrating lymphocytes. Methods The subjects of this retrospective study were 42 patients who had undergone hepatectomy for IHCC. We divided the patients into low LCR and high LCR groups (cutoff value: 8780) and analyzed their overall survival (OS) and disease-free survival (DFS) with respect to LCR and other clinicopathological factors. We also investigated the levels of stromal tumor-infiltrating lymphocytes (TILs) and CD8 + TILs in surgical specimens, and the relationship between LCR and TILs. Results A low LCR was identified in 21 patients and was significantly correlated with older age, a high CRP-albumin ratio, and advanced disease stage, and was a prognostic factor for OS and DFS. Multivariate analysis revealed that a low LCR was an independent prognostic factor for worse OS (HR 10.40, P  = 0.0077). Although the LCR and levels of stromal TILs were not significantly related, LCR and levels of CD8 + TILs were significantly related ( P  = 0.0297). Conclusion The preoperative LCR may predict the postsurgical prognosis of patients with IHCC and reflect the CD8 + TILs.