
Adenocarcinoma of the ampulla of Vater (AOV) is classified into intestinal type (IT) and pancreatobiliary type (PB); however, the immunological properties of these subtypes remain to be characterized. Here, we evaluated the clinical implications of PD-L1 expression and CD8+ T lymphocyte density in adenocarcinomas of the AOV and their potential association with Yes-associated protein (YAP). We analyzed 123 adenocarcinoma-of-the-AOV patients who underwent surgical resection, and tumors were classified into IT or PB type. Tumor or inflammatory cell PD-L1 expression, CD8+ T lymphocyte density in the cancer cell nest (intratumoral) or in the adjacent stroma, and YAP localization and intensity were analyzed using immunohistochemical staining. PB-type tumors showed higher tumoral PD-L1 expression than IT-type tumors, and tumoral PD-L1 expression was associated with a shorter disease-free survival (DFS) [hazard ratio (HR), 1.77; p = 0.045] and overall survival (OS) (HR 1.99; p = 0.030). Intratumoral CD8+ T lymphocyte density was higher in IT type than in PB type and was associated with a favorable DFS (HR 0.47; p = 0.022). The nuclear staining pattern of YAP in tumor cells, compared to non-nuclear staining patterns, was more frequently associated with PB type and increased tumoral PD-L1 expression. Nuclear YAP staining was a significant prognostic factor for OS (HR 2.21; p = 0.022). These results show that the two subtypes of adenocarcinoma of the AOV exhibit significant differences in tumoral PD-L1 expression and intratumoral CD8+ T lymphocyte density, which might contribute to their distinct clinical features.
PD-L1, Male, B7-H1 Antigen/analysis, Ampulla of Vater, Common Bile Duct Neoplasms, Adenocarcinoma/immunology*, 610, Cell Cycle Proteins, Ampulla of Vater*, Adenocarcinoma, CD8-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes/immunology, B7-H1 Antigen, Nuclear Proteins/analysis, Humans, Adenocarcinoma of the ampulla of Vater, Lymphocyte Count, Common Bile Duct Neoplasms/mortality, Transcription Factors/analysis, Aged, Proportional Hazards Models, Common Bile Duct Neoplasms/immunology*, Adenocarcinoma/pathology, Nuclear Proteins, Middle Aged, Prognosis, Immunohistochemistry, Common Bile Duct Neoplasms/pathology, CD8 T lymphocytes, Adenocarcinoma/mortality, Female, YAP, Transcription Factors
PD-L1, Male, B7-H1 Antigen/analysis, Ampulla of Vater, Common Bile Duct Neoplasms, Adenocarcinoma/immunology*, 610, Cell Cycle Proteins, Ampulla of Vater*, Adenocarcinoma, CD8-Positive T-Lymphocytes, CD8-Positive T-Lymphocytes/immunology, B7-H1 Antigen, Nuclear Proteins/analysis, Humans, Adenocarcinoma of the ampulla of Vater, Lymphocyte Count, Common Bile Duct Neoplasms/mortality, Transcription Factors/analysis, Aged, Proportional Hazards Models, Common Bile Duct Neoplasms/immunology*, Adenocarcinoma/pathology, Nuclear Proteins, Middle Aged, Prognosis, Immunohistochemistry, Common Bile Duct Neoplasms/pathology, CD8 T lymphocytes, Adenocarcinoma/mortality, Female, YAP, Transcription Factors
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