The prognostic value of stromal tumor-infiltrating lymphocytes in intrahepatic cholangiocarcinoma: a population-based study

Abstract

Objective

We assess the predictive value impacted by tumor-infiltrating lymphocytes (TILs) for overall survival (OS) and progression-free survival (PFS) in patients with intrahepatic cholangiocarcinoma (ICC) undergoing complete resection.

Methods

Sixty-eight patients with resectable ICC were included in this study. We studied stromal TIL density and scored it by staining sections from surgically resected ICC patients with hematoxylin and eosin (HE). The clinical data and prognosis of patients with ICC were obtained by searching clinical and follow-up records.

Results

A stromal TIL negative status was a predictor of poor OS (HR = 0.41, 95% CI 0.20–0.83, p = .01) and poor PFS (HR = 0.47, 95% CI 0.23–0.97, p = .04) independently. Low stromal TIL density was associated with high levels of CA125 (p = .03) and CA19-9 (p < .01). The high level of CA19-9 (p = .05), high differentiation (p = .02), a large diameter (p = .05), a positive bile duct/vascular cancer embolus (p = .03) and positive satellite nodules (p = .02) were tendencies to develop tumors for patients with a negative status of stromal TIL.

Conclusion

Our data prompt for the prediction of the PFS and OS of patients with ICC after complete resection, stromal TILs play an important role.

Keywords:

• tumor-infiltrating lymphocytes
• intrahepatic cholangiocarcinoma
• prognosis
• progression-free survival (PFS)
• overall survival (OS)

Acknowledgments

The authors express thanks to Professor Li Zhen and Xu Mei, the members of the Department of Pathology, Henan Provincial People's Hospital, for their evaluation of the tumor-infiltrating lymphocytes.

Author contributions

QZ and DK are the co-first authors. QZ and YH designed the study. QZ, HY, YZ and ZH collected the data. QZ and DK were involved in data cleaning, mortality follow-up, and verification. HY and TL analyzed the data. QZ drafted the manuscript. QZ and YH contributed to the interpretation of the results and critical revision of the manuscript for important intellectual content and approved the final version of the manuscript. All authors have read and approved the final manuscript. QZ and YH are the study guarantors. All authors read and approved the final manuscript.

Ethics approval and consent to participate

This research was authorized by the Institutional Review Board of Henan Provincial People's Hospital (2015) Ethics Review No. (27). The study was conducted consistent with the declaration of the 1964 Declaration of Helsinki, as well as its principles of subsequent amendments.

Disclosure statement

The authors declare that they have no competing interests.

Data availability statement

For materials and data requests, please get in touch with the corresponding author.

Additional information

Funding

This study was supported by grant from Henan Medical Science and Technology Project [grant number 201502018] and Henan Medical Science and Technology Project [grant number 2018020412].