Intrahepatic cholangiocarcinoma (ICC) is characterised by heterogeneity, and it can be subdivided into small-duct and large-duct types. Inflammatory and tumour markers could effectively predict prognosis in many cancers, but no similar studies have been conducted in the histological subtypes of ICC. A total of 102 and 72 patients with ICC undergoing curative-intent resection were retrospectively subclassified into large-duct and small-duct types by chemical staining, respectively. The prognostic value of inflammatory and tumour markers was studied for the first time in histological subtypes of ICC by using a Cox regression model. A novel predictor named prognostic inflammatory index (PII) was proposed and defined as (10⁹/L). Survival analysis showed that PII, neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR), carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), CA242, and ferritin were all predictors of DFS and OS in patients with ICC (). Subgroup analysis showed that PII, CA19-9, and ferritin were risk predictors of disease-free survival (DFS) and overall survival (OS) in small-duct type ICC (). In addition, in small-duct type ICC, NLR and LMR were correlated with OS (), whilst CEA and CA242 were correlated with DFS (). In conclusion, PII is a convenient and efficient inflammatory predictor of DFS and OS in ICCs and their small-duct type. NLR and LMR, rather than platelet-to-lymphocyte ratio, were correlated with OS in small-duct type ICC. In addition, ferritin may be a supplement to CA19-9 in stratifying the survival outcome of patients with small-duct type ICC.

中文翻译：

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炎症和肿瘤标志物在小导管亚型肝内胆管癌根治性切除后的预后价值

肝内胆管癌（ICC）具有异质性，可分为小管型和大管型。炎症和肿瘤标志物可以有效预测许多癌症的预后，但尚未对ICC的组织学亚型进行类似的研究。分别通过化学染色将102例和72例进行了根治性切除的ICC患者分别归类为大导管和小导管类型。通过使用Cox回归模型，首次在ICC的组织学亚型中研究了炎症和肿瘤标志物的预后价值。提出了一种新的预测因子，称为预后性炎症指数（PII），其定义为（10 ⁹ / L）。生存分析表明，PII，嗜中性白细胞与淋巴细胞之比（NLR），淋巴细胞与单核细胞之比（LMR），癌胚抗原（CEA），糖类抗原19-9（CA19-9），CA242和铁蛋白都是预测因子ICC患者的DFS和OS的变化（）。亚组分析显示，PII，CA19-9和铁蛋白是小管型ICC中无病生存期（DFS）和总体生存期（OS）的风险预测指标（）。此外，在小管型ICC中，NLR和LMR与OS相关（），而CEA和CA242与DFS相关（）。总之，PII是ICC及其小管型中DFS和OS的便捷，有效的炎症预测因子。在小管型ICC中，NLR和LMR而不是血小板与淋巴细胞的比例与OS相关。此外，铁蛋白可以作为CA19-9的补充，用于分层小管型ICC患者的生存结局。