Serum Lipid-Based Prognostic Model for Advanced Intrahepatic Cholangiocarcinoma Under Chemo-Immunotherapy

Chengzhi Jiang,1,2,* Kaijun Long,1,* Tianyuan Fang,2 Wen Li,2 Liu Yang,2 Pengcheng Chai,2 Ji Tao,2 Kaiguo Long1 1Department of Breast and Thyroid Surgery, The Second Affiliated Hospital of Zunyi Medical University, Zunyi City, Guizhou Province, People’s Republic of China; 2Department of Gastrointestinal Medical Oncology, Harbin Medical University Cancer Hospital, Harbin, Heilongjiang Province, People’s Republic of China*These authors contributed equally to this workCorrespondence: Kaiguo Long, Email LKG5643@163.com Ji Tao, Email taoji66@163.comBackground: Serum lipid levels have been associated with the prognosis of various malignancies.Aim: To develop a novel nomogram based on serum lipid parameters to predict overall survival in patients with intrahepatic cholangiocarcinoma.Methods: Serum lipid profiles and survival data were collected prior to the initiation of chemotherapy combined with immunotherapy. Survival analysis was performed to identify prognostic factors associated with ICC. Independent prognostic factors were used to construct a nomogram. The predictive performance of the nomogram was evaluated. External validation of the survival analysis and nomogram for serum lipids was conducted using a validation cohort.Results: Low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and apolipoprotein A1 were selected for further analysis. Survival analysis demonstrated that patients with low LDL-C, high HDL-C, and high ApoA1 levels exhibited significantly longer OS and PFS. A nomogram incorporating LDL-C and HDL-C was constructed to predict 1-, 2-, and 3-year survival probabilities. The nomogram exhibited favorable predictive performance.Discussion: Pre-treatment serum levels of LDL-C, HDL-C, and ApoA1 exhibited significant prognostic value for advanced ICC. The nomogram constructed based on LDL-C and HDL-C effectively predicted survival outcomes, providing a theoretical basis to support treatment decision-making and individualized prognostic assessment in clinical practice.Keywords: Serum lipid levels, Intrahepatic Cholangiocarcinoma, Immunotherapy, Nomogram