Inflammatory biomarkers in cholangiocarcinoma: A literature review

This review aims to comprehensively examine the role of inflammatory biomarkers such as C-reactive protein, procalcitonin, serum amyloid A (SAA), haptoglobin, ferritin, erythrocyte sedimentation rate, calprotectin, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), plasma viscosity, lymphocyte-to-monocyte ratio, and fibrinogen in the pathogenesis of cholangiocarcinoma (CCA).Elevated serum C-reactive protein levels have been identified as independent prognostic indicators in patients with intrahepatic CCA (iCCA), reflecting systemic inflammatory activity and tumor burden.Increased procalcitonin concentrations have been reported in advanced CCA, particularly during chemotherapy, and may indicate severe systemic inflammatory responses.SAA isoforms, particularly SAA1 and SAA4, are promising diagnostic biomarkers, with SAA1 demonstrating significant alterations in iCCA.Furthermore, terminal fucosylation of haptoglobin in tumor-derived exosomes has emerged as a novel glycan biomarker with potential diagnostic and prognostic utility in CCA.Elevated preoperative serum ferritin levels have been associated with poorer overall survival and recurrence-free survival in patients with iCCA.Similarly, the lymphocyte-to-monocyte ratio serves as an accessible and reliable marker of systemic inflammation and immune status.Fibrinogen contributes to tumor progression through its involvement in coagulation, inflammation, and metastatic dissemination.In addition, NLR, PLR, and SII have demonstrated substantial prognostic value in patients with iCCA.