Prognostic Value of Combined CA19-9 with Aspartate Aminotransferase to Lymphocyte Ratio in Patients with Intrahepatic Cholangiocarcinoma After Hepatectomy

Qiu, Haizhou; Liu, Chang; Huang, Min; Shen, Shu; Wang, Wentao

doi:10.2147/cmar.s320380

Cited by 9 publications

(5 citation statements)

References 49 publications

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“…Intrahepatic duct invasion is the cause of intrahepatic duct dilatation [15], and it is thus rational that the ability of the tumour to infiltrate this duct is correlated with a higher risk of MVI. While higher levels of specific tumour markers, including CEA, CA19-9, and AFP, have been linked to reductions in overall and progression-free survival, they have largely not been found to be associated with ICC patient MVI status [7,[16][17][18][19]. Consistently, we observed no relationship between tumour marker levels and MVI positivity.…”

Section: Discussionsupporting

confidence: 67%

“…While higher levels of specific tumour markers, including CEA, CA19-9, and AFP, have been linked to reductions in overall and progression-free survival, they have largely not been found to be associated with ICC patient MVI status [ 7 , 16 – 19 ]. Consistently, we observed no relationship between tumour marker levels and MVI positivity.…”

Section: Discussionmentioning

confidence: 99%

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Clinical and magnetic resonance imaging features predict microvascular invasion in intrahepatic cholangiocarcinoma

Sun¹,

Qian²,

Shi³

et al. 2023

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Introduction: Clinical features and magnetic resonance imaging (MRI)-related data are commonly employed in clinical settings and can be used to predict the microvascular invasion (MVI) status of intrahepatic cholangiocarcinoma (ICC) patients.Aim: To generate a clinical and MRI-based model capable of predicting the MVI status of ICC patients.Material and methods: Consecutive ICC patients evaluated from June 2015 to December 2018 were retrospectively enrolled in a training group to establish a predictive clinical MRI model. Consecutive ICC patients evaluated from January 2019 to June 2019 were prospectively enrolled in a validation group to test the reliability of this model.Results: In total, 143 patients were enrolled in the training group, of whom 46 (32.2%) and 96 (67.8%) were MVI-positive and MVI-negative, respectively. Logistics analyses revealed larger tumour size (p = 0.008) and intrahepatic duct dilatation (p = 0.01) to be predictive of MVI positivity, enabling the establishment of the following predictive model: -2.468 + 0.024 × tumour size + 1.094 × intrahepatic duct dilatation. The area under the receiver operating characteristic (ROC) curve (AUC) for this model was 0.738 (p < 0.001). An optimal cut-off value of -1.0184 was selected to maximize sensitivity (71.7%) and specificity (61.9%). When the data from the validation group were incorporated into the predictive model, the AUC value was 0.716 (p = 0.009).Conclusions: Both larger tumour size and intrahepatic duct dilatation were predictive of MVI positivity in patients diagnosed with ICC, and the predictive model developed based on these variables can offer quantitative guidance for assessing the risk of MVI.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Clinical and magnetic resonance imaging features predict microvascular invasion in intrahepatic cholangiocarcinoma

Sun¹,

Qian²,

Shi³

et al. 2023

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“…Qiu et al. suggested that incorporating serum CA19-9 to a clinical index showed better value in prognostic stratification than CA19-9 alone ( 34 ). Thus, we proposed a novel index by combination TBS (tumor morphology) and CA19-9 (tumor-specific biomarker), termed CTC grade, and investigated its utility in predicting ICC patient long-term outcomes.…”

Section: Discussionmentioning

confidence: 99%

Tumor Burden Score Stratifies Prognosis of Patients With Intrahepatic Cholangiocarcinoma After Hepatic Resection: A Retrospective, Multi-Institutional Study

Liu

Qiu

et al. 2022

Front. Oncol.

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BackgroundThe prognostic significance of tumor burden score (TBS) on patients who underwent curative-intent resection of intrahepatic cholangiocarcinoma (ICC) has not been evaluated. The present study aimed to investigate the impact of TBS and its synergistic effect with CA19-9 (combination of TBS and CA19-9, CTC grade) on long-term outcomes.MethodsPatients who underwent radical resection of ICC between 2009 and 2017 were retrospectively identified from a multi-center database. The overall survival (OS) and recurrence-free survival (RFS) were examined in relation to TBS, serum preoperative CA19-9, and CTC grade.ResultsA total of 650 patients were included in our study (509 in the derivation cohort and 141 in the validation cohort). Kaplan–Meier curves showed that both TBS and CA19-9 levels were strong predictors of survival outcomes. Patients with elevated TBS grade or elevated CA19-9 were associated with worse OS and RFS (both p < 0.001). As expected, CTC grade also performed well in predicting long-term outcomes. Patients with low TBS/low CA19-9 (CTC grade 1) were associated with the best OS as well as RFS, while high TBS/high CA19-9 (CTC grade 3) correlated to the worst outcomes. In the validation cohort, TBS grade, preoperative CA19-9, and CTC grade also stratified prognosis among patients (p < 0.001 for each).ConclusionsBoth tumor morphology (tumor burden) and tumor-specific biomarker (serum CA19-9) were important when evaluating prognosis of patients with resectable ICC. Serum CA19-9 and TBS showed a synergistic effect on prognostic evaluation. CTC grade was a promising tool in stratifying prognosis of ICC patients after curative resection.

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“… 10 Currently, accumulating evidence has shown that inflammation‐based scores, such as systemic immune‐inflammation index (SII), platelet‐to‐lymphocyte ratio (PLR), neutrophil‐to‐lymphocyte ratio (NLR), lymphocyte‐to‐monocyte ratio (LMR), prognostic nutritional index (PNI), aspartate aminotransferase/platelet count ratio index (APRI), aspartate aminotransferase (AST) to neutrophil ratio index (ANRI), and AST to lymphocyte ratio index (ALRI) could be used as the prognostic markers for cholangiocarcinoma. 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 Gamma‐glutamyl transpeptidase (GGT) to albumin ratio (GAR) was a newly identified inflammation‐based score. Initially, GAR was pointed out to be useful for stratification of patients with chronic hepatitis B.…”

Section: Introductionmentioning

confidence: 99%

Prognostic significance of gamma‐glutamyl transpeptidase to albumin ratio in patients with intrahepatic cholangiocarcinoma after hepatectomy

Liu

et al. 2022

J Cellular Molecular Medi

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Inflammation has been reported to play an important role in tumour progression and prognosis. In this study, we evaluated the prognostic significance of γ‐glutamyl transpeptidase (GGT) to albumin ratio (GAR) in patients with intrahepatic cholangiocarcinoma (ICC) after hepatectomy. We retrospectively analysed 650 ICC patients underwent hepatectomy at three Chinese medical centres between January 2009 and September 2017. Patients were classified into derivation cohort ( n = 509) and validation cohort ( n = 141). Receiver operating characteristic (ROC) curve was used to determine the optimal cut‐off value for GAR. Survival curve and cox regression analysis were applied to assess the prognostic power of GAR. The prognostic accuracy of GAR was compared with other variables by ROC curve. The optimal cut‐off value for GAR was 1.3655. Preoperative high GAR was closely related to tumour number, lymph node invasion and GGT. The survival curve of derivation and validation cohorts showed that patients in the high GAR group had significantly shorter overall survival (OS) and disease‐free survival (DFS) than patients in the low GAR group. Multivariate analysis in the derivation cohort confirmed that GAR was an independent prognostic factor for survival outcomes. Moreover, the ROC curve revealed that GAR had better predictive accuracy than other variables. High GAR predicted poor OS and DFS in ICC patients after hepatectomy. GAR may be a novel, simple and effective prognostic marker for ICC patients.

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Prognostic Value of Combined CA19-9 with Aspartate Aminotransferase to Lymphocyte Ratio in Patients with Intrahepatic Cholangiocarcinoma After Hepatectomy

Cited by 9 publications

References 49 publications

Clinical and magnetic resonance imaging features predict microvascular invasion in intrahepatic cholangiocarcinoma

Clinical and magnetic resonance imaging features predict microvascular invasion in intrahepatic cholangiocarcinoma

Tumor Burden Score Stratifies Prognosis of Patients With Intrahepatic Cholangiocarcinoma After Hepatic Resection: A Retrospective, Multi-Institutional Study

Prognostic significance of gamma‐glutamyl transpeptidase to albumin ratio in patients with intrahepatic cholangiocarcinoma after hepatectomy

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