Correlation of PDL-1 expression with CD8 postive tumor infiltrating lymphocytes and Tumor budding in adenocarcinoma gallbladder

Abstract

Introduction: Gallbladder cancer (GBC) is a prevalent malignancy of the biliary tract, characterized by its aggressive behavior and poor prognosis due to late-stage detection. Despite advancements in diagnostic and therapeutic strategies, the survival rates for GBC patients remain low. Identifying reliable prognostic markers is crucial for improving patient outcomes. Tumor budding, PD-L1 expression, and CD8+ tumor-infiltrating lymphocytes (TILs) have emerged as potential prognostic indicators in various cancers, but their roles in GBC are not well understood.

Objective: This study aims to evaluate the prognostic significance of tumor budding, PD-L1 expression, and CD8+ TILs in patients with gallbladder adenocarcinoma.

Methods: A two-year prospective study was conducted at the Department of Pathology, GSVM Medical College, Kanpur, involving histopathologically confirmed cases of gallbladder adenocarcinoma. Immunohistochemical analysis was performed to assess PD-L1 and CD8+ TILs, while tumor budding was evaluated as a histopathological parameter. The associations between these markers and patient outcomes were statistically analyzed.

Results: The study included 51 participants, with a female predominance (82.4%). Tumor budding was prevalent in 54.9% of cases, with significant associations found between CD8+ TILs and tumor budding (p=0.0029). PD-L1 expression was observed in 21.6% of cases, with a significant correlation between PD-L1 and CD8+ TILs (p=0.034). However, no significant association was observed between PD-L1 expression and tumor budding (p=0.338).

Conclusion: Tumor budding, PD-L1 expression, and CD8+ TILs are significant prognostic markers in gallbladder adenocarcinoma. The study highlights the importance of integrating these markers into routine clinical practice to improve the risk stratification and management of GBC patients. Further research is warranted to explore the therapeutic implications of these findings.