Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand
Patients with distal cholangiocarcinoma (dCCA) generally have poor outcomes because of late presentation and diagnosis. Therefore, prognostic factors for predicting outcomes are essential to improve therapeutic strategies and quality of life. Tumor-infiltrating lymphocytes (TILs) have been reported...
| Main Authors: | , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2022-12-01
|
| Series: | Frontiers in Oncology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.1004220/full |
| _version_ | 1811178258816827392 |
|---|---|
| author | Piyapharom Intarawichian Piyapharom Intarawichian Piyapharom Intarawichian Sirada Sangpaibool Sirada Sangpaibool Sirada Sangpaibool Piya Prajumwongs Piya Prajumwongs Piya Prajumwongs Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Sakkarn Sangkhamanon Sakkarn Sangkhamanon Sakkarn Sangkhamanon Waritta Kunprom Waritta Kunprom Waritta Kunprom Malinee Thanee Malinee Thanee Malinee Thanee Watcharin Loilome Watcharin Loilome Watcharin Loilome Narong Khuntikeo Narong Khuntikeo Narong Khuntikeo Attapol Titapun Attapol Titapun Attapol Titapun Apiwat Jareanrat Apiwat Jareanrat Apiwat Jareanrat Vasin Thanasukarn Vasin Thanasukarn Vasin Thanasukarn Tharatip Srisuk Tharatip Srisuk Tharatip Srisuk Vor Luvira Vor Luvira Vor Luvira Kulyada Eurboonyanun Kulyada Eurboonyanun Kulyada Eurboonyanun Julaluck Promsorn Julaluck Promsorn Julaluck Promsorn Supinda Koonmee Supinda Koonmee Supinda Koonmee Aileen Wee Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri |
| author_facet | Piyapharom Intarawichian Piyapharom Intarawichian Piyapharom Intarawichian Sirada Sangpaibool Sirada Sangpaibool Sirada Sangpaibool Piya Prajumwongs Piya Prajumwongs Piya Prajumwongs Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Sakkarn Sangkhamanon Sakkarn Sangkhamanon Sakkarn Sangkhamanon Waritta Kunprom Waritta Kunprom Waritta Kunprom Malinee Thanee Malinee Thanee Malinee Thanee Watcharin Loilome Watcharin Loilome Watcharin Loilome Narong Khuntikeo Narong Khuntikeo Narong Khuntikeo Attapol Titapun Attapol Titapun Attapol Titapun Apiwat Jareanrat Apiwat Jareanrat Apiwat Jareanrat Vasin Thanasukarn Vasin Thanasukarn Vasin Thanasukarn Tharatip Srisuk Tharatip Srisuk Tharatip Srisuk Vor Luvira Vor Luvira Vor Luvira Kulyada Eurboonyanun Kulyada Eurboonyanun Kulyada Eurboonyanun Julaluck Promsorn Julaluck Promsorn Julaluck Promsorn Supinda Koonmee Supinda Koonmee Supinda Koonmee Aileen Wee Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri |
| author_sort | Piyapharom Intarawichian |
| collection | DOAJ |
| description | Patients with distal cholangiocarcinoma (dCCA) generally have poor outcomes because of late presentation and diagnosis. Therefore, prognostic factors for predicting outcomes are essential to improve therapeutic strategies and quality of life. Tumor-infiltrating lymphocytes (TILs) have been reported as a prognostic predictor in several cancers. However, their role in dCCA is still unclear. This study aimed to evaluate the association of TILs with outcome in patients with dCCA. Fifty-two patients were evaluated for the percentage rate of TILs in their cancers, and a median TIL level was used to divide the patients into two groups. Survival, multivariate, and correlation analyses were performed to determine the prognostic factors. Results showed that a low TIL level was associated with poor survival. Multivariate analysis revealed TILs as an independent factor for poor outcome. Moreover, TILs were markedly correlated with growth patterns, and both were applied to classify patients with dCCA. Subgroups of TILs with growth pattern incorporation improved stratification performance in separating good from poor patient outcomes. This study suggested that TILs could be a prognostic factor for predicting survival and for clustering patients with dCCA to improve prognostication capability. This finding may be incorporated into a new staging system for stratifying dCCA in Thailand. |
| first_indexed | 2024-04-11T06:15:24Z |
| format | Article |
| id | doaj.art-91fd694fbf424e87999b275bb5c979c3 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-11T06:15:24Z |
| publishDate | 2022-12-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Oncology |
| spelling | doaj.art-91fd694fbf424e87999b275bb5c979c32022-12-22T04:41:03ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-12-011210.3389/fonc.2022.10042201004220Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in ThailandPiyapharom Intarawichian0Piyapharom Intarawichian1Piyapharom Intarawichian2Sirada Sangpaibool3Sirada Sangpaibool4Sirada Sangpaibool5Piya Prajumwongs6Piya Prajumwongs7Piya Prajumwongs8Prakasit Sa-Ngiamwibool9Prakasit Sa-Ngiamwibool10Prakasit Sa-Ngiamwibool11Sakkarn Sangkhamanon12Sakkarn Sangkhamanon13Sakkarn Sangkhamanon14Waritta Kunprom15Waritta Kunprom16Waritta Kunprom17Malinee Thanee18Malinee Thanee19Malinee Thanee20Watcharin Loilome21Watcharin Loilome22Watcharin Loilome23Narong Khuntikeo24Narong Khuntikeo25Narong Khuntikeo26Attapol Titapun27Attapol Titapun28Attapol Titapun29Apiwat Jareanrat30Apiwat Jareanrat31Apiwat Jareanrat32Vasin Thanasukarn33Vasin Thanasukarn34Vasin Thanasukarn35Tharatip Srisuk36Tharatip Srisuk37Tharatip Srisuk38Vor Luvira39Vor Luvira40Vor Luvira41Kulyada Eurboonyanun42Kulyada Eurboonyanun43Kulyada Eurboonyanun44Julaluck Promsorn45Julaluck Promsorn46Julaluck Promsorn47Supinda Koonmee48Supinda Koonmee49Supinda Koonmee50Aileen Wee51Chaiwat Aphivatanasiri52Chaiwat Aphivatanasiri53Chaiwat Aphivatanasiri54Cholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Biochemistry, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Yong Loo Lin School of Medicine, National University of Singapore, National University Hospital, Singapore, SingaporeCholangiocarcinoma Screening and Care Program (CASCAP), Khon Kaen University, Khon Kaen, ThailandCholangiocarcinoma Research Institute, Khon Kaen University, Khon Kaen, ThailandDepartment of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, ThailandPatients with distal cholangiocarcinoma (dCCA) generally have poor outcomes because of late presentation and diagnosis. Therefore, prognostic factors for predicting outcomes are essential to improve therapeutic strategies and quality of life. Tumor-infiltrating lymphocytes (TILs) have been reported as a prognostic predictor in several cancers. However, their role in dCCA is still unclear. This study aimed to evaluate the association of TILs with outcome in patients with dCCA. Fifty-two patients were evaluated for the percentage rate of TILs in their cancers, and a median TIL level was used to divide the patients into two groups. Survival, multivariate, and correlation analyses were performed to determine the prognostic factors. Results showed that a low TIL level was associated with poor survival. Multivariate analysis revealed TILs as an independent factor for poor outcome. Moreover, TILs were markedly correlated with growth patterns, and both were applied to classify patients with dCCA. Subgroups of TILs with growth pattern incorporation improved stratification performance in separating good from poor patient outcomes. This study suggested that TILs could be a prognostic factor for predicting survival and for clustering patients with dCCA to improve prognostication capability. This finding may be incorporated into a new staging system for stratifying dCCA in Thailand.https://www.frontiersin.org/articles/10.3389/fonc.2022.1004220/fulltumor-infiltrating lymphocytes (TILs)distal cholangiocarcinomaprognosisgrowth patternpredicting outcome |
| spellingShingle | Piyapharom Intarawichian Piyapharom Intarawichian Piyapharom Intarawichian Sirada Sangpaibool Sirada Sangpaibool Sirada Sangpaibool Piya Prajumwongs Piya Prajumwongs Piya Prajumwongs Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Prakasit Sa-Ngiamwibool Sakkarn Sangkhamanon Sakkarn Sangkhamanon Sakkarn Sangkhamanon Waritta Kunprom Waritta Kunprom Waritta Kunprom Malinee Thanee Malinee Thanee Malinee Thanee Watcharin Loilome Watcharin Loilome Watcharin Loilome Narong Khuntikeo Narong Khuntikeo Narong Khuntikeo Attapol Titapun Attapol Titapun Attapol Titapun Apiwat Jareanrat Apiwat Jareanrat Apiwat Jareanrat Vasin Thanasukarn Vasin Thanasukarn Vasin Thanasukarn Tharatip Srisuk Tharatip Srisuk Tharatip Srisuk Vor Luvira Vor Luvira Vor Luvira Kulyada Eurboonyanun Kulyada Eurboonyanun Kulyada Eurboonyanun Julaluck Promsorn Julaluck Promsorn Julaluck Promsorn Supinda Koonmee Supinda Koonmee Supinda Koonmee Aileen Wee Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri Chaiwat Aphivatanasiri Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand Frontiers in Oncology tumor-infiltrating lymphocytes (TILs) distal cholangiocarcinoma prognosis growth pattern predicting outcome |
| title | Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand |
| title_full | Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand |
| title_fullStr | Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand |
| title_full_unstemmed | Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand |
| title_short | Prognostic significance of tumor-infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in Thailand |
| title_sort | prognostic significance of tumor infiltrating lymphocytes in predicting outcome of distal cholangiocarcinoma in thailand |
| topic | tumor-infiltrating lymphocytes (TILs) distal cholangiocarcinoma prognosis growth pattern predicting outcome |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.1004220/full |
| work_keys_str_mv | AT piyapharomintarawichian prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT piyapharomintarawichian prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT piyapharomintarawichian prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT siradasangpaibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT siradasangpaibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT siradasangpaibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT piyaprajumwongs prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT piyaprajumwongs prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT piyaprajumwongs prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT prakasitsangiamwibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT prakasitsangiamwibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT prakasitsangiamwibool prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT sakkarnsangkhamanon prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT sakkarnsangkhamanon prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT sakkarnsangkhamanon prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT warittakunprom prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT warittakunprom prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT warittakunprom prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT malineethanee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT malineethanee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT malineethanee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT watcharinloilome prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT watcharinloilome prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT watcharinloilome prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT narongkhuntikeo prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT narongkhuntikeo prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT narongkhuntikeo prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT attapoltitapun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT attapoltitapun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT attapoltitapun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT apiwatjareanrat prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT apiwatjareanrat prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT apiwatjareanrat prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vasinthanasukarn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vasinthanasukarn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vasinthanasukarn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT tharatipsrisuk prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT tharatipsrisuk prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT tharatipsrisuk prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vorluvira prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vorluvira prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT vorluvira prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT kulyadaeurboonyanun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT kulyadaeurboonyanun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT kulyadaeurboonyanun prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT julaluckpromsorn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT julaluckpromsorn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT julaluckpromsorn prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT supindakoonmee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT supindakoonmee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT supindakoonmee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT aileenwee prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT chaiwataphivatanasiri prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT chaiwataphivatanasiri prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand AT chaiwataphivatanasiri prognosticsignificanceoftumorinfiltratinglymphocytesinpredictingoutcomeofdistalcholangiocarcinomainthailand |