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

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

Guohe Lin  1   2 , Yongcheng Liu  1   3 , Shuhong Li  1   2   4 , Yize Mao  1   2   5 , Jun Wang  1   2   5 , Zeyu Shuang  1   2   5 , Jianlin Chen  1   2   5 , Shengping Li  1   2   5
Affiliations

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

Guohe Lin et al. Oncotarget. .

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.

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Conflict of interest statement

No potential conflicts of interest were disclosed.

Figures

Figure 1
Figure 1. Elevated NLR was associated with poor anti-tumor immunity
A. The percentage of overall lymphocytes to leukocytes in the high NLR group was significantly lower than that in the low NLR group (p < 0.001). B. The percentage of T cells and CD8+ T cells to total lymphocytes in the high NLR group was significantly lower than that in the low NLR group (p = 0.018; p = 0.006). C., D. The percentage of PD-1+CD4+ and PD-1+CD8+ T cells in the high NLR group were higher than that in the low NLR group (p = 0.045, p = 0.008, n = 5). E., F. The percentage of IFN-γ+CD4+ and IFN-γ+CD8+ T cells in the high NLR group were lower than in the low NLR group (p = 0.012, p = 0.006, n = 5). G. Representative immunohistochemistry images of CD3 in intratumoral regions. Scale bar, 100 μm (a, c), 50μm(b, d). H. The numbers of CD3+ T cells in the high NLR group and in the low NLR group. Cell numbers were calculated as the cell count per ×400 field.
Figure 2
Figure 2. Elevated NLR correlates with a poor prognosis in patients with ICC
The patients with ICC were divided into high NLR group (n = 43) and the low NLR group (n = 59) according to the cutoff of 3. Kaplan-Meier analysis was conducted to disclose the relationship of NLR with the overall survival A. and recurrence-free survival B. (log-rank test).
See this image and copyright information in PMC

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