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Clinicopathological and Prognostic Significance of Immunoscore and PD-L1 in Intrahepatic Cholangiocarcinoma

Authors Wu H, Wei Y, Jian M, Lu H, Song Q, Hao L, Yue Y

Received 2 November 2020

Accepted for publication 18 December 2020

Published 6 January 2021 Volume 2021:14 Pages 39—51

DOI https://doi.org/10.2147/OTT.S288982

Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Tohru Yamada


Hong Wu,1 Yulong Wei,2 Mei Jian,1 Hong Lu,2 Qingzhu Song,3 Liheng Hao,4 Yong Yue4

1Department of Ultrasound, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People’s Republic of China; 2Department of Pathology, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People’s Republic of China; 3Department of Clinical Laboratory, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People’s Republic of China; 4Department of Hepatobiliary Surgery, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People’s Republic of China

Correspondence: Yong Yue
Department of Hepatobiliary Surgery, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People’s Republic of China
Tel +86 18504789505
Fax +86 04788415386
Email nmgbsyycs@126.com

Background: An increasing amount of evidence reveals that immunosuppression is a major issue in cancer progression. The association of immunoscore (IS) and its impact on clinical outcome have been studied in many tumor types, but its significance in intrahepatic cholangiocarcinoma (ICC) is poorly known.
Methods: By immunohistochemistry, CD3 and CD8 expressions were assessed in tissue samples of 50 cases of postoperative ICC. The IS was determined by analyzing CD3+ and CD8+ expression data in different areas (intratumor and invasion margins). The relationship between IS and clinicopathological characteristics, including the overall survival (OS) and recurrence-free survival (RFS), was analyzed. In addition, PD-L1, a major regulator of immune escape, was also assessed in tumor cells by immunohistochemistry.
Results: IS was related to histological differentiation (P=0.026), the presence of lymphoid metastasis (P=0.034), and TNM clinical stages (P = 0.031) of ICC. High IS was significantly associated with better RFS (P=0.033) and OS (P=0.014). IS was an independent prognostic factor for better OS in multivariate analysis. PD-L1 expression was closely related to tumor vascular invasion (P=0.044). Although there was no association between PD-L1 expression and IS, high PD-L1 expression in tumor cells indicated poor RFS (P=0.017) and OS (P=0.004) in ICC.
Conclusion: The IS and PD-L1 may be used as a complement to the TNM system for predicting the prognosis of patients with ICC.

Keywords: intrahepatic cholangiocarcinoma, microenvironment, immunoscore, PDL1, prognosis

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