Declined Preoperative Aspartate Aminotransferase to Neutrophil Ratio Index Predicts Poor Prognosis in Patients with Intrahepatic Cholangiocarcinoma after Hepatectomy.
- Author:
Lingyun LIU
1
;
Wei WANG
;
Yi ZHANG
;
Jianting LONG
;
Zhaohui ZHANG
;
Qiao LI
;
Bin CHEN
;
Shaoqiang LI
;
Yunpeng HUA
;
Shunli SHEN
;
Baogang PENG
Author Information
- Publication Type:Original Article
- Keywords: Aspartate aminotransferase; Neutrophil; Cholangiocarcinoma; Prognosis; Biomarkers
- MeSH: Alanine Transaminase; Aspartate Aminotransferases*; Aspartic Acid*; Biomarkers; Blood Platelets; Carcinoembryonic Antigen; Cholangiocarcinoma*; Disease-Free Survival; Hepatectomy*; Hepatitis B; Humans; Leukocytes; Lymph Nodes; Lymphocytes; Multivariate Analysis; Neoplasm Metastasis; Neutrophils*; Prognosis*; Recurrence; Retrospective Studies; ROC Curve
- From:Cancer Research and Treatment 2018;50(2):538-550
- CountryRepublic of Korea
- Language:English
- Abstract: PURPOSE: Various inflammation-based prognostic biomarkers such as the platelet to lymphocyte ratio and neutrophil to lymphocyte ratio, are related to poor survival in patients with intrahepatic cholangiocarcinoma (ICC). This study aims to investigate the prognostic value of the aspartate aminotransferase to neutrophil ratio index (ANRI) in ICC after hepatic resection. MATERIALS AND METHODS: Data of 184 patients with ICC after hepatectomy were retrospectively reviewed. The cut-off value of ANRI was determined by a receiver operating characteristic curve. Preoperative ANRI and clinicopathological variables were analyzed. The predictive value of preoperative ANRI for prognosis of ICC was identified by univariate and multivariate analyses. RESULTS: The optimal cut-off value of ANRI was 6.7. ANRI was associated with tumor size, tumor recurrence, white blood cell, neutrophil count, aspartate aminotransferase, and alanine transaminase. Univariate analysis showed that ANRI, sex, tumor number, tumor size, tumor differentiation, lymph node metastasis, resection margin, clinical TNM stage, neutrophil count, and carcinoembryonic antigen were markedly correlated with overall survival (OS) and disease-free survival (DFS) in patients with ICC. Multivariable analyses revealed that ANRI, a tumor size > 6 cm, poor tumor differentiation, and an R1 resection margin were independent prognostic factors for both OS and DFS. Additionally, preoperative ANRI also had a significant value to predict prognosis in various subgroups of ICC, including serum hepatitis B surface antigen‒negative and preoperative elevated carbohydrate antigen 19-9 patients. CONCLUSION: Preoperative declined ANRI is a noninvasive, simple, and effective predictor of poor prognosis in patients with ICC after hepatectomy.
