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Objective  Immunotherapy targeting the programmed cell death protein-1 (PD-1)/programmed cell death protein ligand 1 (PD-L1) pathway has been observed to be efficient in several solid tumors. We aim to investigate the prognostic significance of PD-1/PD-L1 expression profile in intrahepatic cholangiocarcinoma (ICC).    Materials and methods  We investigated the expression of PD-1, PD-L1, CD8 +  T cells, and CD68 +  macrophages in paired tumor and adjacent normal tissues from 322 ICC patients using tyramide signal amplification (TSA)-based multiplexed immunohistochemistry.    Results  We found that high proportion of tumor-infiltrating CD8 +  PD-1 High  within CD8 +  PD-1 +  T cells significantly correlated with advanced TNM stage ( P  = 0.035). ICC patients with high proportion of CD8 +  PD-1 High  in CD8 +  PD-1 +  had worse postoperative survival than low proportion patients ( P  = 0.0037), which was an independently prognostic factor for OS ( P  = 0.025,). The density of CD68 +  PD-L1 +  significantly and positively correlated with the density of CD8 +  PD-1 High  ( P  < 0.0001,  r  = 0.5927). The proportion of CD68 +  PD-L1 +  within CD68 +  ICC was the risk factor for OS and TTR but not an independently factor for prognosis. The CD68 +  PD-L1 +  macrophages and CD8 +  PD-1 High  T cells may cooperatively play a role in inhibiting anti-tumor immunity.    Conclusion  CD68 +  PD-L1 +  macrophages and CD8 +  PD-1 High  T cells predict unfavorable prognosis, which could also bring new progress about immune target therapy in ICC research.    Supplementary Information  The online version contains supplementary material available at 10.1186/s12957-020-02082-5.

PD-1/PD-L1 expression profiles within intrahepatic cholangiocarcinoma predict clinical outcome