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Clinical Implications of Cytotoxic T Lymphocyte Antigen-4 Expression on Tumor Cells and Tumor-Infiltrating Lymphocytes in Extrahepatic Bile Duct Cancer Patients Undergoing Surgery Plus Adjuvant Chemoradiotherapy

Title
Clinical Implications of Cytotoxic T Lymphocyte Antigen-4 Expression on Tumor Cells and Tumor-Infiltrating Lymphocytes in Extrahepatic Bile Duct Cancer Patients Undergoing Surgery Plus Adjuvant Chemoradiotherapy
Authors
Lim, Yu JinKoh, JaemoonKim, KyuboChie, Eui KyuKim, SehuiLee, Kyoung BunJang, Jin-YoungKim, Sun WheOh, Do-YounBang, Yung-Jue
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2017
Journal Title
TARGETED ONCOLOGY
ISSN
1776-2596JCR Link1776-260XJCR Link
Citation
vol. 12, no. 2, pp. 211 - 218
Publisher
SPRINGER
Indexed
SCIE; SCOPUS WOS scopus
Abstract
There currently is only limited knowledge on the role of tumor-specific immunity in cholangiocarcinoma. This study evaluated the clinical implications of cytotoxic T lymphocyte antigen-4 (CTLA-4) expression levels and CD4(+) and CD8(+) tumor-infiltrating lymphocytes (TILs) in extrahepatic bile duct (EHBD) cancer. Immunohistochemistry of CTLA-4, CD4, and CD8 was performed for 77 EHBD cancer patients undergoing surgery plus adjuvant chemoradiotherapy. CTLA-4 expression on tumor cells and TILs were assessed by using H-scores and the proportion of CTLA-4(+) lymphocytes, respectively. With optimal cutoff values determined by a maximal chi-square method with overall survival (OS) data, patients with CTLA-4 H-score > 70 and a proportion of CTLA-4(+) TILs > 0.15 showed higher mean density of CD8(+) and CD4(+) TILs, respectively (P = 0.025 for CD8(+) and P = 0.055 for CD4(+) TILs). The high CTLA-4 H-score level was associated with prolonged OS and disease-free interval (DFI) (P = 0.025 and 0.004, respectively). With differential levels of CTLA-4 H-score according to hilar and non-hilar locations (high rate 32 vs. 68%, respectively; P = 0.013), an exploratory subgroup analysis demonstrated that the associations between the CTLA-4 expression and OS and DFI were confined to hilar tumors (P = 0.003 and < 0.001, respectively), but not to non-hilar ones (P = 0.613 and 0.888, respectively). This study demonstrates a potential prognostic relevance of CTLA-4 expression in EHBD cancer. We suggest a differential survival impact of the CTLA-4 expression level according to different tumor locations.
DOI
10.1007/s11523-016-0474-1
Appears in Collections:
의과대학 > 의학과 > Journal papers
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