Preoperative lymphocyte/C-reactive protein ratio and its correlation with CD8+ tumor-infiltrating lymphocytes as a predictor of prognosis after resection of intrahepatic cholangiocarcinoma

Abstract Background Lymphocyte/C-reactive protein (CRP) ratio (LCR), is a promising prognostic factor that can reflect tumor inflammation and systemic patient condition. The aim of this study was to investigate whether preoperative LCR can be a prognostic factor for post-surgical outcomes among patients with intrahepatic cholangiocarcinoma (IHCC). We also investigated the relationship between LCR and tumor infiltrating lymphocytes (TILs) to clarify whether systemic host immune parameters reflect local tumor immunity.Methods We enrolled 45 patients who had undergone hepatectomy for IHCC. Patients were divided into low LCR and high LCR groups, according to reactive operating characteristic curve (Cut-off value: 8780). We analyzed their overall survival (OS) and disease-free survival (DFS) with respect to LCR and other clinicopathological factors. We also investigated stromal TILs and numbers of CD8+ TILs in surgical specimens, and the relationship between LCR and TILs.Results Twenty-one patients (46.7%) were associated with low LCR. Low LCR was significantly correlated with older age, high CRP and advanced disease stage, and was a prognostic factor for OS and DFS. And multivariate analysis revealed that low LCR was an independent prognostic factor for worse OS (HR: 2.81 P<0.04). Regarding the relationship between LCR and local tumor immunity, while LCR and levels for stromal TILs were significantly related, LCR and levels for CD8+ TILs were significantly related. Conclusions Preoperative LCR levels could predict the post-surgical prognosis of patients with IHCC, and reflected numbers of intra-tumoral CD8+ TILs.Trial registration This study was approved by Tokushima University Hospital ethics committee and with the approval of corresponding regulatory agencies, and all the experiments were carried out in accordance with the approved guidelines (Tokushima Clinical Trial Management System Number; 3215). All the patients involved in this study signed informed consent forms and agreed to participate.

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Prognostic Implications of Lymphocyte/C-Reactive Protein Ratio With Tumor-Infiltrating Lymphocytes in Resected Intrahepatic Cholangiocarcinoma

10.21203/rs.3.rs-131092/v1 ◽

2020 ◽

Author(s):

Katsuki Miyazaki ◽

Yuji Morine ◽

Satoru Imura ◽

Tetsuya Ikemoto ◽

Yu Saito ◽

...

Keyword(s):

Prognostic Factor ◽

Tumor Immunity ◽

Intrahepatic Cholangiocarcinoma ◽

Tumor Infiltrating Lymphocytes ◽

Disease Stage ◽

C Reactive Protein ◽

Local Tumor ◽

Reactive Protein ◽

Infiltrating Lymphocytes ◽

The Relationship

Abstract BackgroundLymphocyte/C-reactive protein (CRP) ratio (LCR), is a promising prognostic factor that can reflect tumor inflammation and systemic patient condition. The aim of this study was to investigate whether preoperative LCR can be a prognostic factor for post-surgical outcomes among patients with intrahepatic cholangiocarcinoma (IHCC). We also investigated the relationship between LCR and tumor infiltrating lymphocytes (TILs) to clarify whether systemic host immune parameters reflect local tumor immunity.MethodsWe enrolled 45 patients who had undergone hepatectomy for IHCC. Patients were divided into low LCR and high LCR groups, according to reactive operating characteristic curve (Cut-off value: 8836). We analyzed their overall survival (OS) and disease-free survival (DFS) with respect to LCR and other clinicopathological factors. We also investigated stromal TILs and numbers of CD8+ TILs in surgical specimens, and the relationship between LCR and TILs.ResultsTwenty-one patients (46.7%) were associated with low LCR. Low LCR was significantly correlated with older age, high CRP and advanced disease stage, and was a prognostic factor for OS and DFS. And multivariate analysis revealed that low LCR was an independent prognostic factor for worse OS (HR: 2.81 P<0.04). Regarding the relationship between LCR and local tumor immunity, while LCR and levels for stromal TILs were significantly related, LCR and levels for CD8+ TILs were significantly related. ConclusionsPreoperative LCR levels could predict the post-surgical prognosis of patients with IHCC, and reflected numbers of intra-tumoral CD8+ TILs.Trial registrationThis study was approved by Tokushima University Hospital ethics committee and with the approval of corresponding regulatory agencies, and all the experiments were carried out in accordance with the approved guidelines (Tokushima Clinical Trial Management System Number; 3215). All the patients involved in this study signed informed consent forms and agreed to participate.

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Lymphocyte‐C‐reactive protein ratio as a novel prognostic index in intrahepatic cholangiocarcinoma: A multicentre cohort study

Liver International ◽

10.1111/liv.14567 ◽

2020 ◽

Cited By ~ 1

Author(s):

Liang‐He Lu ◽

Chong Zhong ◽

Wei Wei ◽

Shao‐Hua Li ◽

Jie Mei ◽

...

Keyword(s):

Cohort Study ◽

Intrahepatic Cholangiocarcinoma ◽

Prognostic Index ◽

C Reactive Protein ◽

Protein Ratio ◽

Reactive Protein ◽

Multicentre Cohort Study ◽

Multicentre Cohort

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Lymphocyte–C-reactive protein ratio as a prognostic marker associated with the tumor immune microenvironment in intrahepatic cholangiocarcinoma

International Journal of Clinical Oncology ◽

10.1007/s10147-021-01962-4 ◽

2021 ◽

Author(s):

Kyohei Yugawa ◽

Shinji Itoh ◽

Tomoharu Yoshizumi ◽

Akinari Morinaga ◽

Norifumi Iseda ◽

...

Keyword(s):

Prognostic Marker ◽

Intrahepatic Cholangiocarcinoma ◽

C Reactive Protein ◽

Immune Microenvironment ◽

Protein Ratio ◽

Reactive Protein ◽

Tumor Immune Microenvironment

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Faculty Opinions recommendation of Patterns of c-reactive protein RATIO response in severe community-acquired pneumonia: a cohort study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.14267367.15779587 ◽

2012 ◽

Author(s):

Charles Feldman ◽

Erica Shaddock

Keyword(s):

Cohort Study ◽

Community Acquired Pneumonia ◽

C Reactive Protein ◽

Protein Ratio ◽

Reactive Protein ◽

Severe Community Acquired Pneumonia ◽

Ratio Response

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Lymphocyte C-reactive protein ratio: A new biomarker to predict early complications after gastrointestinal oncologic surgery

Cancer Biomarkers ◽

10.3233/cbm-210251 ◽

2021 ◽

pp. 1-9

Author(s):

Murat Yildirim ◽

Bulent Koca

Keyword(s):

Colorectal Cancer ◽

Postoperative Complications ◽

Inflammatory Markers ◽

Operation Time ◽

C Reactive Protein ◽

Oncologic Surgery ◽

Protein Ratio ◽

Colorectal Cancer Surgery ◽

Neutrophil Lymphocyte Ratio ◽

Reactive Protein

BACKGROUND: Lymphocyte-to-C-reactive protein ratio (LCR) has been used as a post-surgical prognostic biomarker in patients with gastric and colorectal cancer. However, its relationship with early postoperative complications in these patients is unknown. In this study, we aimed to reveal the relationship between LCR and postoperative complications. METHODS: Eighty-one patients operated for stomach and colorectal cancer between January 2020 and August 2020 were prospectively analyzed. On preoperative and postoperative days 1, 3 and 5, other inflammatory parameters, mainly LCR, neutrophil lymphocyte ratio (NLR), were recorded. The patients were divided into two groups according to Clavien-Dindo classification as stage III and higher complications major, stage I-II/non-complication minor. RESULTS: Fifty seven patients were operated for colorectal cancer, 24 patients for gastric cancer. The mean age of the patients was 65.6 ± 12.6, 34.6% of them was women. Age, operation time and hospital stay were significantly different between the groups (p= 0.004, p= 0.002, p< 0.001). Major complications developed in 18 patients. On postoperative day 5, LCR found superior diagnostic accuracy in predicting major postoperative complications compared to other inflammatory markers. On the postoperative 5th day, the cut-off value of LCR was 0.0034, 88.8% (71.9–94.8) sensitivity, and 85.7% (73.6–95.4) selectivity. CONCLUSION: Among different inflammatory markers, postoperative LCR is a safe and effective predictor of postoperative complications, especially after gastric and colorectal cancer surgery on day 5.

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