Evaluating prognostic value of biliary stone in intrahepatic cholangiocarcinoma by propensity score matching analysis

Background: To explore biliary tract stone (BTS) as prognostic factors of intrahepatic cholangiocarcinoma (ICC).Methods: Clinical data of 985 ICC patients were classified into no BTS group and BTS group-subgrouped into hepatolithiasis (HL) and non-hepatolithiasis (NHL) group.Propensity score matching was utilized to mitigate baseline characteristics.Preoperative peripheral inflammation parameters (PPIP) were further investigated.Immunostaining of CD3, CD4, CD8, CD68, PD1 and PD-L1 were conducted.Results: Overall survival (OS) of patients without BTS surpassed BTS group (P = 0.040) while no difference of time to recurrence (TTR) was observed (P = 0.146).HL group had shorter OS and TTR than HL-matched group (P < 0.001 and P = 0.017, respectively) and survival time of NHL group differed not with NHL-matched group (P > 0.05).PPIP like neutrophils to lymphocytes ratio (NLR), platelet to lymphocyte ratio (PLR) and systemic immune inflammation (SII) of HL group exceeded no BTS group or NHL group (all P < 0.05).Associations of PPIP and tumorous immunocytes differed vastly among HL group, NHL group and no BTS group.Tumorous CD4 + /CD3 + ratio and PD1 + /CD3 + ratio of HL group surpassed those in no BTS group (P = 0.036 and P < 0.001, respectively) and NHL group (P = 0.015 and 0.002, respectively).Para-tumorous CD68 + macrophages exceeded that in tumor samples of HL group (P < 0.001).No difference of CD8 + /CD3 + lymphocyte ratio and PD-L1 rank were detected.Conclusions: Hepatolithiasis, rather than extra-hepatic biliary stone, is a poor prognostic indicator of ICC.Immunotherapy is promising in treating HL-related ICC.