Prediction of overall survival in resectable intrahepatic cholangiocarcinoma: ISICC-applied prediction model
Prediction of overall survival in resectable intrahepatic cholangiocarcinoma: ISICC-applied prediction model
复制标题
可切除肝内胆管癌总生存率的预测：IS(ICC) 应用预测模型。
DOI：
10.1111/cas.14315
复制
发表时间：
2020-02-12
期刊：
影响因子：
5.7
通讯作者：
Shi, Yinghong
中科院分区：
文献类型：
--
作者：
Tian, Mengxin;Liu, Weiren;Shi, Yinghong
肝内胆管癌（ICC）是一种高度异质性的疾病，预后较差。肿瘤浸润淋巴细胞可预测多种癌症，但其在ICC中的预后价值尚不清楚。共有168例接受肝切除术的ICC患者被纳入衍生队列。采用免疫组化方法检测肿瘤及肿瘤周围16种免疫标记物。最小绝对收缩和选择算子模型用于识别预后标记物并建立ICC （ISICC）的免疫特征。应用isicc建立了预测模型，并在另一个独立数据集上进行了验证。五个免疫特征，包括CD3（肿瘤周围(P)）， CD57(P), CD45RA(P), CD66b（肿瘤内(T)）和PD-L1(P)，被确定并整合到每个患者的个体化ISICC中。将总胆红素、肿瘤数量、CEA、CA19-9、GGT、HBsAg和ISICC等7项预后预测指标整合到最终模型中。应用isicc的预测模型在衍生队列中的c指数为0.719 (95% CI, 0.660-0.777)，在验证队列中的c指数为0.667 （95% CI, 0.581-0.732）。与传统分期系统相比，该模型具有更好的同质性和较低的赤池信息准则值。应用isicc的预测模型在临床实践中对可切除ICC患者的总生存期有较好的预测效果。
Intrahepatic cholangiocarcinoma (ICC) remains a highly heterogeneous disease with poor prognosis. Tumor-infiltrating lymphocytes were predictive in various cancers, but their prognostic value in ICC is less clear. A total of 168 ICC patients who had received liver resection were enrolled and assigned to the derivation cohort. Sixteen immune markers in tumor and peritumor regions were examined by immunohistochemistry. A least absolute shrinkage and selection operator model was used to identify prognostic markers and to establish an immune signature for ICC (ISICC). An ISICC-applied prediction model was built and validated in another independent dataset. Five immune features, including CD3(peritumor (P)), CD57(P), CD45RA(P), CD66b(intratumoral (T)) and PD-L1(P), were identified and integrated into an individualized ISICC for each patient. Seven prognostic predictors, including total bilirubin, tumor numbers, CEA, CA19-9, GGT, HBsAg and ISICC, were integrated into the final model. The C-index of the ISICC-applied prediction model was 0.719 (95% CI, 0.660-0.777) in the derivation cohort and 0.667 (95% CI, 0.581-0.732) in the validation cohort. Compared with the conventional staging systems, the new model presented better homogeneity and a lower Akaike information criteria value in ICC. The ISICC-applied prediction model may provide a better prediction performance for the overall survival of patients with resectable ICC in clinical practice.