Association of TREM1 expression with mTOR and DRP1 in gallbladder cancer: a study of 105 cases

BACKGROUND: Gallbladder cancer is highly aggressive and characterized by poor prognosis and limited treatment options. TREM1 (Triggering Receptor Expressed on Myeloid cells 1) may be involved in cancer inflammation and progression, but its relevance to gallbladder cancer is poorly understood. Expression of TREM1 in gallbladder cancer and correlation with mTOR activation, DRP1 upregulation, and clinical outcomes were investigated in the present study. METHODS: Immunohistochemical staining of 105 gallbladder cancer specimens from patients receiving cholecystectomy, radical resection or palliative resection between 2015 and 2020 was conducted to show expression of TREM1, mTOR and DRP1. Data was analyzed by Chi-square test, Kaplan-Meier survival curve, Cox regression model and correlation analyses. RESULTS: High TREM1 expression was observed in 63% gallbladder cancer cases and was linked to a more advanced T stage (p = 0.015), the presence of lymph node metastasis (p = 0.041) and an elevated TNM stage (p = 0.006). Positive correlations were shown between TREM1 and mTOR (p < 0.001) and between TREM1 and DRP1 (p < 0.001). Patients with high TREM1 expression had shorter overall survival than those with low expression (median 18 months vs. 50 months, p < 0.001). TREM1 was identified by multivariate analysis as an independent prognostic factor (HR = 1.838, 95% CI: 1.038-3.252, p = 0.037). CONCLUSIONS: Immunohistochemical analysis demonstrated that TREM1 is overexpressed in gallbladder cancer and positively correlated with mTOR and DRP1 expression. TREM1 may be a suitable prognostic biomarker and therapeutic target in gallbladder cancer.