Correlation Of Preoperative NLR、LMR、GGT/CA19-9 And ALBI Scores With Prognosis In Patients With Hilar Cholangiocarcinoma After Radical Resection

Objective: To analyze the correlation between preoperative peripheral blood NLR,LMR,GGT/CA19-9,ALBI scores and prognosis of patients with hilar cholangiocarcinoma(HCCA)after radical resection,so as to provide some theoretical basis for judging the prognosis.Methods: Retrospective study was conducted on patients with HCCA who received radical resection in Shengjing Hospital Affiliated to China Medical University from January 1,2013 to December 31,2021.After screening by inclusion and exclusion criteria,110 patients were finally included in this study.Then the Kaplan-Meier curves of patients were drawn and the difference in survival between groups was compared by log-rank test.Equal proportional risk COX regression analysis was used to assess the relationship between clinical variables and patient mortality.Results: According to the optimal cut-off value,patients were divided into low level NLR group(≤2.33)and high level NLR group(>2.33),low level LMR group(≤4.50)and high level LMR group(>4.50),low level GGT/CA19-9 group(≤4.28)and high level GGT/CA19-9 group(>4.28),low ALBI grading group(level 1 and level 2)and high ALBI grading group(level 3).The preoperative NLR,LMR,GGT/CA19-9 and ALBI grade were related to the survival rate of HCCA patients after radical resection,and the difference was statistically significant(P<0.05).Low level LMR,low level GGT/CA19-9,ALBI grade 3,tumor diameter greater than 2cm,lymph node metastasis and low differentiation suggest poor prognosis of HCCA patients(P<0.05);Preoperative low level LMR,low level GGT/CA19-9,tumor diameter greater than 2cm,lymph node metastasis and low differentiation were independent risk factors affecting the prognosis of HCCA patients after radical resection(P<0.05);In addition,the multivariate COX regression result which index of P<0.05 is simplified as the prognosis score with the weight of each variable being 1.The total score>7 is defined as high risk,and vice versa.Survival analysis showed that patients in the high-risk group had worse outcomes than those in the low-risk group.Conclusion: Preoperative low level LMR,low level GGT/CA19-9,tumor diameter greater than 2cm,lymph node metastasis and low differentiation are independent risk factors for prognosis of patients with HCCA after radical resection.The preoperative NLR and ALBI grade can assist in evaluating the prognosis.The scoring system based on preoperative blood indexes has certain clinical guiding significance for judging the prognosis of patients with HCCA after radical resection.