Abstract
AIMS: To explore the prognostic value of the combined SII-PNI (Systemic Immune-Inflammation Index + Prognostic Nutritional Index) in cholangiocarcinoma (CCA) patients. METHODS: Retrospective analysis of 149 CCA patients' clinical data was conducted, with the SII-PNI scoring system used to assess its prognostic impact. RESULTS: Chi-square analysis showed SII-PNI correlated with CEA and CA19-9 (p < 0.05). Kaplan-Meier curves revealed significant progression-free survival (PFS) differences among SII-PNI groups (p < 0.005). Cox univariate analysis identified AST, CA19-9, and CEA as PFS prognostic factors (p < 0.05), but only SII-PNI was an independent factor in multivariate analysis (p < 0.005). CONCLUSION: SII-PNI (integrating inflammation and nutrition) effectively predicts CCA's PFS (HR = 1.51, p < 0.005), outperforming conventional biomarkers like CA19-9. Its cost-effectiveness supports CCA risk stratification. However, SII-PNI-based dynamic treatment response monitoring is unvalidated (retrospective limitation) and needs prospective trials; no intensified treatment recommendations are made.