The Prognostic Value of Stromal Tumor-Infiltrating Lymphocytes in Intrahepatic Cholangiocarcinoma

Abstract

Objective: We conducted this study to assess the predictive value of tumor-infiltrating lymphocytes (TILs) for progression-free survival (PFS) and overall survival (OS) in intrahepatic cholangiocarcinoma (ICC) patients after 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 ICC patients were obtained by searching clinical and follow-up records. Results: A stromal TIL negative status was an independent predictor of poor OS (HR=2.84, 95% CI 1.48- 5.46, P<0.01) and poor PFS (HR=2.88, 95% CI 1.44-5.76, P<0.01). Low stromal TIL density was associated with high CA125 (P=0.03) and CA19-9 (P<0.01) levels. Patients with a stromal TIL negative status tended to develop tumors with a high level of CA19-9 (P=0.05), high differentiation (P=0.02), a large diameter (P=0.05), a positive bile duct/vascular cancer embolus (P=0.03) and positive satellite nodules (P=0.02). Conclusion: Our data suggest that stromal TILs play an important role in predicting the PFS and OS of ICC patients after complete resection.