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Prognostic value of CRP-albumin-lymphocyte index in patients with intrahepatic cholangiocarcinoma after radical

Shi-Qian Lang¹, Jun-Jie Kong¹, Guang-Bing Li¹

¹Department of Liver Transplantation and Hepatobiliary Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China.

Frontiers in Medicine

|March 21, 2025

Summary

The C-reactive protein (CRP)-Albumin-Lymphocyte (CALLY) index shows prognostic value for intrahepatic cholangiocarcinoma (ICC) patients after surgery. This index and a derived nomogram model offer more accurate survival predictions than TNM staging.

Keywords:

immunity inflammation intrahepatic cholangiocarcinoma nomogram nutrition prognosis

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Area of Science:

Oncology
Surgical Oncology
Biomarkers

Background:

Intrahepatic cholangiocarcinoma (ICC) is a rare but aggressive biliary tract cancer.
Accurate prognostic markers are crucial for guiding treatment and improving patient outcomes after radical resection.
Existing staging systems may not fully capture the complex prognostic factors in ICC.

Purpose of the Study:

To investigate the prognostic significance of the CRP-Albumin-Lymphocyte (CALLY) index in patients with ICC undergoing radical resection.
To develop and validate a nomogram prediction model based on the CALLY index for overall survival (OS) and recurrence-free survival (RFS).

Main Methods:

Retrospective analysis of clinical data from 286 ICC patients who underwent radical surgery.
Univariate and multivariate Cox regression analyses to assess the association between the CALLY index and survival outcomes.
Development of a nomogram prediction model and evaluation of its accuracy using C-index, calibration curves, DCA, and ROC curves.

Main Results:

An optimal CALLY index cut-off value of 1.81 was identified.
A CALLY index <1.81 was found to be an independent risk factor for OS and RFS (p < 0.05).
The CALLY index demonstrated a higher area under the curve (AUC) compared to other inflammatory markers (NLR, PLR, SII, mGPS).
The nomogram model showed strong survival prediction efficacy and superior prognostic value compared to the TNM staging system.

Conclusions:

The CALLY index is an independent predictor of OS and RFS in patients with ICC following radical resection.
A nomogram model incorporating the CALLY index provides a more accurate and effective tool for predicting long-term prognosis in ICC patients.
The CALLY index-based nomogram outperforms TNM staging in prognostic accuracy for ICC after surgery.