Elevated neutrophil-to-lymphocyte ratio is an independent poor prognostic factor in patients with intrahepatic cholangiocarcinoma
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Guohe Lin1,2,*, Yongcheng Liu1,4,*, Shuhong Li1,2,5,*, Yize Mao1,2,3, Jun Wang1,2,3, Zeyu Shuang1,2,3, Jianlin Chen1,2,3 and Shengping Li1,2,3
1 State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
2 National Collaborative Innovation Center for Cancer Medicine, Guangzhou, China
3 Department of Hepatobiliary Oncology, Sun-Yat-sen University Cancer Center, Guangzhou, China
4 Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
5 Department of Endoscopy, Sun Yat-sen University Cancer Center, Guangzhou, China
* These authors have contributed equally to this work
Shengping Li, email:
Keywords: intrahepatic cholangiocarcinoma, neutrophil-to-lymphocyte ratio, CD4+ T cells, CD8+ T cells, prognosis
Received: July 23, 2015 Accepted: February 13, 2016 Published: February 24, 2016
We investigated whether elevated neutrophil-to-lymphocyte ratio ( NLR ) was associated with poor anti-tumor immunity and prognosis in patients with intrahepatic cholangiocarcinoma ( ICC ). Clinicopathologic data of 102 patients with ICC who underwent hepatectomy was retrospectively analyzed. The Kaplan-Meier method and Cox regression model were used to analyze the survival and prognosis. The percentage of overall lymphocytes , T cells and CD8+ T cells in the high NLR group was lower than that in the low NLR group. The percentage of PD-1+CD4+ and PD-1+CD8+ T cells was higher and the percentage of IFN-γ+CD4+ and IFN-γ+CD8+ T cells was lower in the high NLR group than that in the low NLR group ( p = 0.045, p = 0.008; p = 0.012, p = 0.006 ). Density of tumor-infiltrating CD3+ T cells in the high NLR group was lower than that in the low NLR group ( p < 0.001 ). Elevated NLR was an independent predictor for poor overall survival ( OS; p = 0.035 ) and recurrence-free survival ( RFS; p = 0.008 ). These results indicate that elevated NLR is associated with poor anti-tumor immunity and could be a poor biomarker for prognosis in patients with ICC.
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