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High ratio of programmed cell death protein 1 (PD-1)(+)/CD8(+) tumor-infiltrating lymphocytes identifies a poor prognostic subset of extrahepatic bile duct cancer undergoing surgery plus adjuvant chemoradiotherapy

Cited 31 time in Web of Science Cited 33 time in Scopus
Authors
Lim, Yu Jin; Koh, Jaemoon; Kim, Kyubo; Chie, Eui Kyu; Kim, BoKyong; Lee, Kyoung Bun; Jang, Jin-Young; Kim, Sun-Whe; Oh, Do-Youn; Bang, Yung-Jue; Ha, Sung W.
Issue Date
2015-10
Citation
Radiotherapy and Oncology, Vol.117 No.1, pp.165-170
Keywords
Programmed cell death 1 proteinProgrammed cell death 1 ligand 1 proteinCD8Bile duct neoplasmsAdjuvant chemoradiotherapy
Abstract
Background and purpose: This study investigated the prognostic role of PD-L1 expression, PD-1(+) tumor-infiltrating lymphocytes (TILs), and the ratio of PD-1(+)/CD8(+) TILs in extrahepatic bile duct (EHBD) cancer. Materials and methods: We analyzed 83 patients with EHBD cancer who underwent curative surgery plus fluoropyrimidine-based chemoradiotherapy (CRT). Expressions of PD-L1, PD-1, and CD8 were assessed by immunohistochemistry. Results: Fifty-six (68%) patients were PD-L1-positive, and its lower expression level was associated with hilar tumor location (P = 0.044). A higher ratio of PD-1(+)/CD8(+) TILs was associated with poorer overall survival (OS) (P = 0.032), relapse-free survival (RFS) (P = 0.024), and distant metastasis-free survival (DMFS) (P = 0.039) in Kaplan-Meier analyses, but survival differences were not observed according to the PD-L1 expression level. With Cox proportional hazards models, the ratio of PD-1(+)/CD8(+) TILs was the independent prognostic factor in OS (HR 2.47, 95% CI 1.04-5.86), RFS (HR 2.41, 95% CI 1.08-5.41), and DMFS (HR 2.67, 95% CI 1.00-7.11) after adjusting for other significant clinicopathologic variables. Conclusion: A strong survival impact of the ratio of PD-1(+)/CD8(+) TILs was observed in EHBD cancer. In the poor prognostic subgroup, the blockade of the immune checkpoint in combination with conventional multimodality treatment needs to be considered. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
ISSN
0167-8140
URI
https://hdl.handle.net/10371/173213
DOI
https://doi.org/10.1016/j.radonc.2015.07.003
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College of Medicine/School of Medicine (의과대학/대학원)Internal Medicine (내과학전공)Journal Papers (저널논문_내과학전공)
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