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已发表论文
一项关于系统性炎症生物标志物用于预测 iCCA 患者预后的多中心研究
Authors Tao Y, Xu B, Tang J, Ji S, Li J
Received 3 July 2025
Accepted for publication 6 November 2025
Published 11 November 2025 Volume 2025:18 Pages 15787—15800
DOI https://doi.org/10.2147/JIR.S551284
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Felix Marsh-Wakefield
Yun Tao,1 Benjie Xu,2 Jie Tang,1 Shengjun Ji,3 Jie Li1
1Department of Intervention, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China; 3Department of Radiotherapy and Oncology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People’s Republic of China
Correspondence: Jie Li, Department of Intervention, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Email Lj1982020@126.com Shengjun Ji, Department of Radiation and Oncology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, No. 16 West Baita Road, Suzhou, 215001, People’s Republic of China, Email drshengjunji@njmu.edu.cn
Background: The prognostic value of systemic inflammatory biomarkers in intrahepatic cholangiocarcinoma (iCCA) remains uncertain. This study aimed to compare their predictive performance and identify the most effective indicator.
Methods: We retrospectively analyzed 312 iCCA patients who underwent curative resection at three medical centers (2014– 2022). Twelve systemic inflammatory biomarkers, derived from routine blood parameters (neutrophils, lymphocytes, monocytes, platelets, albumin), were assessed for overall survival (OS) and disease-free survival (DFS). Prognostic accuracy was evaluated using the concordance index (C-index), time-dependent area under the ROC curve (time-AUC), and Brier score. Independent predictors identified by multivariate Cox regression were incorporated into nomograms to estimate survival.
Results: The median patient age was 63 years, 71.8% were male, 38.8% had stage III disease, and 37.5% had poorly differentiated tumors. Median follow-up was 24 months. Among the twelve biomarkers, the pan-immune-inflammation value (PIV) demonstrated the strongest prognostic performance. For OS, PIV achieved a C-index of 0.682, time-AUC of 0.695, and Brier score of 0.180; for DFS, C-index was 0.679, time-AUC 0.681, and Brier score 0.192. Unlike single-ratio indices, PIV integrates neutrophil, monocyte, platelet, and lymphocyte counts, providing a multidimensional view of systemic inflammation and immunity. Multivariate analysis confirmed high PIV as an independent predictor of poor OS (HR = 2.488; 95% CI: 1.745– 3.546; P < 0.001) and DFS (HR = 2.353; 95% CI: 1.701– 3.247; P < 0.001). Nomograms combining PIV with clinicopathological factors (CEA, CA19-9, perineural invasion, TNM stage) demonstrated improved discrimination and calibration at 12, 36, and 60 months.
Conclusion: PIV provides superior prognostic value compared with traditional inflammatory indices, offering a cost-effective and readily available biomarker for iCCA. While promising, these results are based on a retrospective multicenter cohort without independent validation, and should be confirmed in prospective external studies.
Keywords: intrahepatic cholangiocarcinoma, inflammation, biomarker, prognosis
1Department of Intervention, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, People’s Republic of China; 2Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang, People’s Republic of China; 3Department of Radiotherapy and Oncology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, Jiangsu, People’s Republic of China
Correspondence: Jie Li, Department of Intervention, Affiliated Hospital of Jiangnan University, Wuxi, Jiangsu, 214000, People’s Republic of China, Email Lj1982020@126.com Shengjun Ji, Department of Radiation and Oncology, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, No. 16 West Baita Road, Suzhou, 215001, People’s Republic of China, Email drshengjunji@njmu.edu.cn
Background: The prognostic value of systemic inflammatory biomarkers in intrahepatic cholangiocarcinoma (iCCA) remains uncertain. This study aimed to compare their predictive performance and identify the most effective indicator.
Methods: We retrospectively analyzed 312 iCCA patients who underwent curative resection at three medical centers (2014– 2022). Twelve systemic inflammatory biomarkers, derived from routine blood parameters (neutrophils, lymphocytes, monocytes, platelets, albumin), were assessed for overall survival (OS) and disease-free survival (DFS). Prognostic accuracy was evaluated using the concordance index (C-index), time-dependent area under the ROC curve (time-AUC), and Brier score. Independent predictors identified by multivariate Cox regression were incorporated into nomograms to estimate survival.
Results: The median patient age was 63 years, 71.8% were male, 38.8% had stage III disease, and 37.5% had poorly differentiated tumors. Median follow-up was 24 months. Among the twelve biomarkers, the pan-immune-inflammation value (PIV) demonstrated the strongest prognostic performance. For OS, PIV achieved a C-index of 0.682, time-AUC of 0.695, and Brier score of 0.180; for DFS, C-index was 0.679, time-AUC 0.681, and Brier score 0.192. Unlike single-ratio indices, PIV integrates neutrophil, monocyte, platelet, and lymphocyte counts, providing a multidimensional view of systemic inflammation and immunity. Multivariate analysis confirmed high PIV as an independent predictor of poor OS (HR = 2.488; 95% CI: 1.745– 3.546; P < 0.001) and DFS (HR = 2.353; 95% CI: 1.701– 3.247; P < 0.001). Nomograms combining PIV with clinicopathological factors (CEA, CA19-9, perineural invasion, TNM stage) demonstrated improved discrimination and calibration at 12, 36, and 60 months.
Conclusion: PIV provides superior prognostic value compared with traditional inflammatory indices, offering a cost-effective and readily available biomarker for iCCA. While promising, these results are based on a retrospective multicenter cohort without independent validation, and should be confirmed in prospective external studies.
Keywords: intrahepatic cholangiocarcinoma, inflammation, biomarker, prognosis