Wu Hong, Wei Yulong, Jian Mei, Lu Hong, Song Qingzhu, Hao Liheng, Yue Yong
Department of Ultrasound, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China.
Department of Pathology, Inner Mongolia Bayannaoer City Hospital, Bayannaoer 015000, Inner Mongolia, People's Republic of China.
Onco Targets Ther. 2021 Jan 6;14:39-51. doi: 10.2147/OTT.S288982. eCollection 2021.
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.
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.
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 (=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.
The IS and PD-L1 may be used as a complement to the TNM system for predicting the prognosis of patients with ICC.
越来越多的证据表明免疫抑制是癌症进展中的一个主要问题。免疫评分（IS）及其对临床结局的影响已在多种肿瘤类型中进行了研究，但其在肝内胆管癌（ICC）中的意义尚不清楚。
通过免疫组织化学法评估50例ICC术后组织样本中CD3和CD8的表达。通过分析不同区域（肿瘤内和浸润边缘）的CD3+和CD8+表达数据来确定IS。分析IS与临床病理特征之间的关系，包括总生存期（OS）和无复发生存期（RFS）。此外，还通过免疫组织化学法在肿瘤细胞中评估免疫逃逸的主要调节因子PD-L1。
IS与ICC的组织学分化（P=0.026）、淋巴转移情况（P=0.034）和TNM临床分期（P = 0.031）有关。高IS与更好的RFS（P=0.033）和OS（P=0.014）显著相关。在多变量分析中，IS是OS改善的独立预后因素。PD-L1表达与肿瘤血管侵犯密切相关（P=0.044）。虽然PD-L1表达与IS之间无关联，但肿瘤细胞中高PD-L1表达表明ICC患者的RFS（P=0.017）和OS（P=0.004）较差。
IS和PD-L1可作为TNM系统的补充，用于预测ICC患者的预后。
