High CD8(+) and absence of Foxp3(+) T lymphocytes infiltration in gallbladder tumors correlate with prolonged patients survival

BACKGROUND: Gallbladder cancer (GBC), although infrequent in industrialized countries, has high incidence rates in certain world regions, being a leading cause of death among elderly Chilean women. Surgery is the only effective treatment, and a five-year survival rate of advanced-stage patients is less than 10%. Hence, exploring immunotherapy is relevant, although GBC immunogenicity is poorly understood. This study examined the relationship between the host immune response and GBC patient survival based on the presence of tumor-infiltrating lymphocytes at different disease stages. METHODS: Tumor tissues from 80 GBC patients were analyzed by immunohistochemistry for the presence of CD3(+), CD4(+), CD8(+), and Foxp3(+) T cell populations, and the results were associated with clinical stage and patient survival. RESULTS: The majority of tumor samples showed CD3(+) T cell infiltration, which correlated with better prognosis, particularly in advanced disease stages. CD8(+), but not CD4(+), T cell infiltration correlated with improved survival, particularly in advanced disease stages. Interestingly, a < 1 CD4(+)/CD8(+) T cell ratio was related with increased survival. Additionally, the presence of Foxp3(+) T cells correlated with decreased patient survival, whereas a ≤ 1 Foxp3(+)/CD8(+) T cell ratio was associated with improved patient survival. CONCLUSIONS: Depending on the disease stage, the presence of CD8(+) and absence of Foxp3(+) T cell populations in tumor tissues correlated with improved GBC patient survival, and thus represent potential markers for prognosis and management of advanced disease, and supports testing of immunotherapy. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12885-018-4147-6) contains supplementary material, which is available to authorized users.