Association of PD-L1 Expression with Lymph Node Metastasis and Clinical Stage in Ampulla of Vater Cancer: An Observational Study.

Abstract

Background: Ampulla of Vater cancer is a subtype of periampullary cancer originating from pancreatic ducts and the bile ducts. Immune checkpoint proteins, particularly Programmed Death-Ligand 1 (PD-L1), show a crucial function in influencing cancer progression, tumor microenvironment, and immune evasion. This study investigates the association between PD-L1 expression and clinical characteristics in patients with ampulla of Vater cancer.

Methods: A retrospective observational study was carried out at a general hospital in West Java, Indonesia, from July 2019 to June 2024. Forty-four patients diagnosed with ampulla of Vater cancer were included. PD-L1 expression was evaluated using immunohistochemistry, and clinicopathological data were analyzed using chi-square, Mann-Whitney, and independent t-tests.

Results: There were 44 research subject. The PD-L1 expression was positive in 59.1% of patients and negatively associated with carcinoembryonic antigen (CEA) levels (p = 0.010). There was a significant association between PD-L1 positivity and lymph node involvement (p = 0.042) and clinical stage (p = 0.017). No significant association was found between PD-L1 expression and age, sex, histopathological grade, or distant metastasis.

Conclusion: PD-L1 expression in ampulla of Vater cancer is significantly associated with higher lymph node metastasis and advanced clinical stage but not with age, sex, or tumor differentiation. These findings suggest PD-L1 as a potential prognostic marker and therapeutic target.