A retrospective multicenter study: postoperative prognostic value of the lymphocyte-C-reactive protein ratio combined with the Ki-67 index in gallbladder cancer.

Abstract

We investigated the predictive value of the lymphocyte-to-C-reactive protein ratio (LCR) and Ki-67 index for postoperative prognosis in gallbladder cancer (GBC). This study included 180 patients with GBC who underwent radical resection, with 2-year postoperative recurrence-free survival (RFS) as the primary endpoint. Patients were divided into event (70 cases) and event-free (110 cases) groups depending on the occurrence of RFS. Ki-67 expression in tumor tissues was detected by immunohistochemistry. Univariate Cox regression and least absolute shrinkage and selection operator-Cox regression were adopted to explore the correlations of LCR and Ki-67 index with postoperative RFS, with Kaplan-Meier survival analysis and receiver operating characteristic curve analysis to evaluate their impacts on postoperative RFS and assess their predictive efficacy. The event group had lower LCR and higher Ki-67 index versus the event-free group. During follow-up, 70 RFS events (38.89%) and 30 OS events (16.67%) were observed. Low LCR and high Ki-67 index were linked to shorter RFS. Multivariate Cox analysis confirmed LCR (HR = 0.144, 95%CI: 0.064-0.325, P < 0.001) and Ki-67 index (HR = 1.058, 95%CI: 1.025-1.091, P < 0.001) to be independently correlated with RFS. Their combination showed moderate predictive performance for 2-year postoperative RFS events. GBC patients with postoperative RFS events present lower preoperative LCR and higher tumoral Ki-67 index. The two biomarkers are independently related to postoperative RFS, showing certain predictive value for 2-year postoperative RFS events. They are promising tools for postoperative risk stratification and adjuvant treatment decision-making in patients with GBC.