Combining Immunoscore with Clinicopathologic Features in Cholangiocarcinoma: An Influential Prognostic Nomogram

Zi-You Wu; Wei Shen; Juan-Qing Yue; Wen-Yan Yao; Shi-Lei Liu; Yun-Peng Jin; Ping Dong; Fei Ma; Xiang-Song Wu; Wei Gong

doi:10.2147/OTT.S274754

Combining Immunoscore with Clinicopathologic Features in Cholangiocarcinoma: An Influential Prognostic Nomogram

Onco Targets Ther. 2020 Nov 6:13:11359-11376. doi: 10.2147/OTT.S274754. eCollection 2020.

Authors

Zi-You Wu^{1

2}, Wei Shen³, Juan-Qing Yue⁴, Wen-Yan Yao^{1

2}, Shi-Lei Liu^{1

2}, Yun-Peng Jin^{1

2}, Ping Dong^{1

2}, Fei Ma^{1

2}, Xiang-Song Wu^#^{1

2}, Wei Gong^#^{1

2}

Affiliations

¹ Department of General Surgery, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.
² Shanghai Key Laboratory of Biliary Tract Disease Research, Shanghai, People's Republic of China.
³ Shanghai Colorectal Cancer Research Center, Shanghai, People's Republic of China.
⁴ Department of Pathology, Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: The aim of this study was to determine the Immunoscore as an independent prognostic factor for cholangiocarcinoma and establish a useful prognostic model for postoperative patients.

Methods: This retrospective study was performed to assess the correlation between the clinicopathological features, tumor immune microenvironment, and prognosis of 76 patients with cholangiocarcinoma. Multivariate analysis was used to identify independent factors significantly associated with local recurrence-free survival (LRFS) and overall survival (OS). Finally, we constructed a nomogram combining the Immunoscore with clinicopathologic features to predict postoperative recurrence and OS.

Results: The present study showed that immune cell infiltration was negatively correlated with tumor size, peripheral vascular invasion, lymph node metastasis, and tumor staging. Kaplan-Meier curves indicated that a decreased Immunoscore was associated with poor prognosis. Multivariate analysis demonstrated that resection type, number of tumors, lymph node metastasis, TNM staging, and the Immunoscore were significantly associated with LRFS. For OS, the significantly correlated factors included resection type, peripheral vascular invasion, TNM staging, and the Immunoscore. Immunoscore was superior to TNM staging in predicting both LRFS and OS according to the receiver operating characteristic analysis. Based on the results of the Cox regression analysis, a prognostic nomogram for the postoperative recurrence of cholangiocarcinoma and OS of patients was established.

Conclusion: The results of this study suggest that the Immunoscore may be used as an independent predictor of postoperative recurrence and OS of patients with cholangiocarcinoma. The Immunoscore appears to offer distinct advantages over the TNM staging system. By combining the Immunoscore and clinicopathological features, the proposed nomogram provides a more accurate predictive tool for postoperative patients with cholangiocarcinoma.

Keywords: Immunoscore; cholangiocarcinoma; immune microenvironment; nomogram; prognosis.

Grants and funding

This study was supported by the National Natural Science Foundation of China (No.81974371), the Emerging Frontier Program of Hospital Development Center (No. SHDC12018107), the General Surgery Construction Program of Shanghai Municipal Health Commission (No. 2017ZZ02011), the Project of Excellent Young Scholars from Shanghai Municipal Health and Family Planning Commission (No. 2018YQ10), the Talent Development Fund from Shanghai Municipal Human Resources and Social Security Bureau (No. 2018048), the Experiment Animal Program of Shanghai Science and Technology Committee Innovative (No. 19140902700), and Research Team of High-level Local Universities in Shanghai and Shanghai Key Laboratory of Biliary Tract Disease Research Foundation (No. 17DZ2260200). The sponsor(s) had no involve in any of the stages from study design to submission of the paper for publication.