Elevated neutrophil-to-lymphocyte ratio is an independent poor prognostic factor in patients with intrahepatic cholangiocarcinoma

Oncotarget. 2016 Aug 9;7(32):50963-50971. doi: 10.18632/oncotarget.7680.

Abstract

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.

Keywords: CD4+ T cells; CD8+ T cells; intrahepatic cholangiocarcinoma; neutrophil-to-lymphocyte ratio; prognosis.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / immunology*
  • Bile Duct Neoplasms / mortality
  • Cholangiocarcinoma / immunology*
  • Cholangiocarcinoma / mortality
  • Disease-Free Survival
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Lymphocyte Count
  • Lymphocytes / immunology*
  • Male
  • Middle Aged
  • Neutrophils / immunology*
  • Prognosis
  • Proportional Hazards Models
  • Retrospective Studies