Medical Research: Emerging Concepts and Applications Vol. 6

Intrahepatic cholangiocarcinoma (iCCA) is an aggressive biliary tract malignancy for which practical blood-based markers may facilitate the identification of patients requiring further diagnostic evaluation. This study evaluated peripheral blood inflammatory indices and circulating cytokines as potential markers of advanced iCCA. Baseline laboratory data were analysed from 40 healthy volunteers and 45 patients with advanced iCCA. Neutrophil-to-lymphocyte ratio, lymphocyte-to-monocyte ratio (LMR), platelet-to-lymphocyte ratio and systemic immune-inflammation index were calculated from complete blood counts, while serum cytokines were measured by flow cytometry. Diagnostic performance was assessed using receiver operating characteristic analysis and logistic regression. Patients with iCCA had significantly lower LMR and higher interleukin-6 (IL6) concentrations than healthy volunteers. LMR showed an area under the receiver operating characteristic curve of 0.91, with a sensitivity of 0.91 and a specificity of 0.85 at a cut-off below 7.2. IL6 yielded an area under the curve of 0.81, with a sensitivity of 0.70 and a specificity of 0.91 at a cut-off above 11.635 pg/mL. Logistic regression identified LMR and IL6 as important discriminating variables, and probability-based categories were derived for both markers. These findings indicate that LMR and IL6 may assist in distinguishing patients with advanced iCCA from healthy individuals. Because LMR can be calculated from a routine complete blood count, it may offer a practical candidate marker for further investigation. Larger, age-matched studies involving relevant hepatobiliary disease controls and external validation are required before clinical screening use can be established.