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. 2024 Apr 11;12(4):844.
doi: 10.3390/biomedicines12040844.

Interleukin-6 and Lymphocyte-to-Monocyte Ratio Indices Identify Patients with Intrahepatic Cholangiocarcinoma

Teerachat Saeheng  1 , Juntra Karbwang  2 , Kesara Na-Bangchang  1   2
Affiliations

Interleukin-6 and Lymphocyte-to-Monocyte Ratio Indices Identify Patients with Intrahepatic Cholangiocarcinoma

Teerachat Saeheng et al. Biomedicines. .

Abstract

Background and aims: Intrahepatic cholangiocarcinoma (iCCA) is a fatal biliary tract cancer with a dismal prognosis due to ineffective diagnostic tools with limited clinical utility. This study investigated peripheral blood indices and cytokine levels to diagnose iCCA.

Methods: Blood samples were collected from healthy subjects (n = 48) and patients with advanced-stage iCCA (n = 47) during a phase I and then phase II trial, respectively. Serum cytokines were measured using a flow cytometer. The peripheral blood indices were estimated based on laboratory data. Multi-linear regression analysis was applied, followed by a probability transformation. The cut-off value and model accuracy were determined using the receiver operating curve (ROC) and the area under the curve (AUC).

Results: The interleukin-6 (IL6) and lymphocyte-to-monocyte ratio (LMR) were potential predictors of iCCA [AUC = 0.91 (0.85-0.97) and 0.81 (0.68-0.93); sensitivity = 0.70 and 0.91; specificity = 0.91 and 0.85, respectively]. Patients with IL6 concentrations higher than 11.635 pg/mL (OR = 23.33, p < 0.001) or LMR lower than 7.2 (OR = 58.08, p < 0.001) are at risk of iCCA development. Patients with IL6 levels higher than 21.83 pg/mL, between 15.95 and 21.83 pg/mL, between 8.8 and 15.94 pg/mL, and lower than 8.8 pg/mL were classified as very high-, high-, intermediate-, and low-risk, respectively. Patients with an LMR between 1 and 3.37, 3.38 and 5.76, 5.77 and 7.18, and higher than 7.18 were classified as very high-, high-, intermediate-, and low-risk, respectively.

Conclusions: LMR is recommended for iCCA screening since the estimation is based on a routine laboratory test, which is available in most hospitals.

Keywords: biliary tract cancer; biomarkers; hepatobiliary cancer; intrahepatic cholangiocarcinoma; prognostic predictor.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
A flow chart of reasons for exclusion from the study.
Figure 2
Figure 2
A flow chart of reasons for exclusion of patients with advanced-stage iCCA from the study.
Figure 3
Figure 3
ROC of LMR.
Figure 4
Figure 4
ROC of IL6.
See this image and copyright information in PMC

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