Joint neutrophil-to-lymphocyte ratio-systemic inflammation response index score as an independent prognostic biomarker for immunotherapy-treated intrahepatic cholangiocarcinoma.
- 1The Eighth Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Abstract
This study aimed to evaluate the predictive value of the systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR), individually and combined, for therapeutic response and survival prognosis in intrahepatic cholangiocarcinoma (ICC) patients receiving immunotherapy. We retrospectively analyzed 100 ICC patients (immunotherapy group, n=82; non-immunotherapy group, n=18) treated between March 2020 and March 2025. Relationships between inflammatory markers and short-term outcomes were assessed via correlation analysis and logistic regression. The predictive performance of the joint NLR-SIRI score was evaluated using receiver operating characteristic (ROC) curves. Overall survival (OS) was analyzed using Kaplan-Meier methods and multivariate Cox regression. Significant baseline differences between groups were observed in inflammatory markers and other clinical features (P<0.05). In the immunotherapy group, multivariate logistic regression showed that NLR was significantly associated with short-term efficacy [odds ratio (OR) =0.768, P=0.02]. The joint NLR-SIRI score outperformed individual markers in predicting short-term response [area under the curve (AUC) =0.709]. Patients with a low inflammatory burden (score 0) had a progressive disease (PD) rate of only 25.81%, whereas those with a high burden (score 1-2) had an 80.00% PD rate (P<0.001). Multivariate Cox regression confirmed that high baseline SIRI [hazard ratio (HR) =7.617, P=0.01] and high NLR (HR =3.074, P=0.03) were independent unfavorable prognostic factors for OS. Furthermore, the joint score enabled significant multilayer survival risk stratification (P=0.004). Pre-treatment SIRI and NLR independently predict long-term survival in ICC patients on immunotherapy. The joint NLR-SIRI model effectively identifies patients at high risk for early treatment failure and facilitates precise survival stratification, offering an accessible, economical tool to guide personalized clinical management.
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BibTeX
@article{lian2026joint,
title = {{Joint neutrophil-to-lymphocyte ratio-systemic inflammation response index score as an independent prognostic biomarker for immunotherapy-treated intrahepatic cholangiocarcinoma.}},
author = {Kena Lian and Honggang Cao and Zizhuang Si and Jian Ma and Bingbing Qiao},
journal = {Translational cancer research},
year = {2026},
month = sep,
doi = {10.21037/tcr-2026-1574},
url = {https://europepmc.org/article/MED/42997701},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Joint neutrophil-to-lymphocyte ratio-systemic inflammation response index score as an independent prognostic biomarker for immunotherapy-treated intrahepatic cholangiocarcinoma.
AU - Kena Lian
AU - Honggang Cao
AU - Zizhuang Si
AU - Jian Ma
AU - Bingbing Qiao
PY - 2026
DA - 2026/09/28
JO - Translational cancer research
DO - 10.21037/tcr-2026-1574
UR - https://europepmc.org/article/MED/42997701
AB - This study aimed to evaluate the predictive value of the systemic inflammation response index (SIRI) and neutrophil-to-lymphocyte ratio (NLR), individually and combined, for therapeutic response and survival prognosis in intrahepatic cholangiocarcinoma (ICC) patients receiving immunotherapy. We retrospectively analyzed 100 ICC patients (immunotherapy group, n=82; non-immunotherapy group, n=18) treated between March 2020 and March 2025. Relationships between inflammatory markers and short-term outcomes were assessed via correlation analysis and logistic regression. The predictive performance of the joint NLR-SIRI score was evaluated using receiver operating characteristic (ROC) curves. Overall survival (OS) was analyzed using Kaplan-Meier methods and multivariate Cox regression. Significant baseline differences between groups were observed in inflammatory markers and other clinical features (P<0.05). In the immunotherapy group, multivariate logistic regression showed that NLR was significantly associated with short-term efficacy [odds ratio (OR) =0.768, P=0.02]. The joint NLR-SIRI score outperformed individual markers in predicting short-term response [area under the curve (AUC) =0.709]. Patients with a low inflammatory burden (score 0) had a progressive disease (PD) rate of only 25.81%, whereas those with a high burden (score 1-2) had an 80.00% PD rate (P<0.001). Multivariate Cox regression confirmed that high baseline SIRI [hazard ratio (HR) =7.617, P=0.01] and high NLR (HR =3.074, P=0.03) were independent unfavorable prognostic factors for OS. Furthermore, the joint score enabled significant multilayer survival risk stratification (P=0.004). Pre-treatment SIRI and NLR independently predict long-term survival in ICC patients on immunotherapy. The joint NLR-SIRI model effectively identifies patients at high risk for early treatment failure and facilitates precise survival stratification, offering an accessible, economical tool to guide personalized clinical management.
SN - 2218-676X
SN - 2219-6803
ER -