Title:Circulating Immune Cells Predict Prognosis and Clinical Response to
Chemotherapy in Cholangiocarcinoma
Volume: 32
Issue: 3
Author(s): Huina Shi, Zhaosheng Li and Mingchen Zhu*
Affiliation:
- Department of Clinical Laboratory, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research &
The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China
Keywords:
Cholangiocarcinoma, circulating immune cells, prognosis, biomarker, chemotherapy, hepatectomy.
Abstract:
Background: The immune system is linked to the prognosis and response to
treatment of patients with cancer. However, the clinical implication of peripheral blood
immune cells in cholangiocarcinoma (CCA) remains vague. Thus, we aimed to assess
whether peripheral circulating immune cells could be used as an indicator for prognosis
and chemotherapeutic efficacy in CCA.
Methods: The distributions of immune subsets were analyzed in peripheral blood samples
from 141 patients with CCA and 131 healthy volunteers by using flow cytometry.
The variation in the subset distribution in the two groups and the relationship between
clinicopathological features and the subpopulations were investigated. Meanwhile, we
assessed the implications of lymphocyte subsets as predictors of chemotherapy outcomes
and overall survival (OS).
Results: The proportion of total lymphocytes decreased, while the percentages of activated
T cells as well as CD4+CD25+ regulatory T cells (Tregs) increased in CCA. Notably,
lymphocyte proportion decreased in patients with regional lymph node (N) (p=0.016)
and distant metastasis (M) (p= 0.001). Furthermore, our study showed that peripheral
blood lymphocyte subsets were significantly correlated with chemotherapy efficacy,
with increased proportions of CD3+ cells (p=0.021) and CD4+ cells (p=0.016) in the effective
group. Finally, the Kaplan-Meier analysis indicated that patients with high natural
killer (NK) cell proportion might have prolonged OS (p = 0.028).
Conclusion: The relationship between circulating immune cells with prognosis and chemotherapy
response in patients with CCA highlights their potential application as an indicator
of CCA prognosis and stratification of chemotherapy response.
