Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 28, 2015; 21(16): 4961-4968
Published online Apr 28, 2015. doi: 10.3748/wjg.v21.i16.4961
Prognostic value of neutrophil distribution in cholangiocarcinoma
Zhi-Yuan Mao, Guang-Qing Zhu, Mei Xiong, Li Ren, Li Bai
Zhi-Yuan Mao, Guang-Qing Zhu, Department of Oncology, Air Force General Hospital of PLA, Beijing 100142, China
Mei Xiong, Department of Blood Transfusion, Air Force General Hospital of PLA, Beijing 100142, China
Li Ren, Department of Pathology, Air Force General Hospital of PLA, Beijing 100142, China
Li Bai, Department of Oncology, Chinese PLA General Hospital, Beijing 100853, China
Author contributions: Mao ZY contributed to the study conception and design, experimental research and data analysis, and manuscript preparation; Zhu GQ performed the clinical studies; Xiong M contributed to the literature search and data acquisition; Ren L performed the statistical analysis; Bai L revised the manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Zhi-Yuan Mao, Department of Oncology, Air Force General Hospital of PLA, No. 30 Fucheng Road, Haidian District, Beijing 100142, China. maozhiyuan666@163.com
Telephone: +86-10-66928571 Fax: +86-10-66928571
Received: October 19, 2014
Peer-review started: October 20, 2014
First decision: November 14, 2014
Revised: November 29, 2014
Accepted: January 21, 2015
Article in press: January 21, 2015
Published online: April 28, 2015
Processing time: 189 Days and 18.5 Hours
Abstract

AIM: To explore the relationship of clinicopathological features and the distribution of neutrophils in the tumor microenvironment with the prognosis of cholangiocarcinoma.

METHODS: Two hundred and fifty-four formalin-fixed and paraffin embedded tissue blocks were analyzed, including tissues from cholangiocarcinoma (n = 254), and tumor adjacent tissues (n = 238). Tissue sections were stained for CD15 using immunohistochemical staining. CD15 expression was detected to identify the distribution of neutrophils in the local tumor microenvironment. The neutrophil density of the tumor tissues and the adjacent tumor tissues was detected to reflect their inflammatory status. Clinical data and follow-up information of cholangiocarcinoma patients who underwent surgery from January 2004 to December 2010 were analyzed retrospectively. The relationship between clinicopathological features and the distribution of neutrophils with prognosis of the patients were analyzed.

RESULTS: The positive expression level of CD15 was only significantly related to the TNM stage. CD15 expression was higher in tumor tissues than in adjacent tissues (73.6% vs 54.6%), with significant differences. Patients with high expression of CD15 had significantly shorter overall survival (OS) than those with low expression of CD15 (median overall survival time 39.77 mo vs 16.87 mo, P = 0.008). Patients with high CD15 expression had significantly shorter disease free survival time (DFS) than those with low expression of CD15 (median DFS 38.27 mo vs 16.83 mo, P = 0.029). COX multivariate analysis indicated that high CD15 expression in tumor tissues was an independent risk factor for predicting OS for patients with cholangiocarcinoma [P = 0.012, relative risk (RR) = 1.601], but it was not an independent risk factor for predicting DFS (P = 0.073, RR = 1.462).

CONCLUSION: Patients with high CD15 expression in cancer tissues had shorter DFS and OS. High expression of CD15 is an independent risk factor for OS.

Keywords: Cholangiocarcinoma; Surgery; Neutrophils; CD15; Prognosis; Tumor microenvironment

Core tip: Inflammation is the 7th important feature to promote tumor development. However, whether inflammation promotes tumor growth in cholangiocarcinoma remains unclear. This study analyzed the inflammation in the tumor microenvironment of the cholangiocarcinoma tissues, and further elaborated the mechanisms of inflammation in cholangiocarcinoma occurrence, development and metastasis, and provided new insights into the treatment of cholangiocarcinoma.