Consistent with other studies in these patients, infiltration of CD8+ T cells and CD163+ M2 macrophages were both significantly associated with longer and shorter patient survival in our CCA cohorts, respectively4,5,48–50 but the FOXp3+ regulatory T cells reported to suppress immune responses against tumor cells and to be correlated with poor clinical outcome has remained an opposing finding compared to other types of cancers51. This evidence concerns the gene CD8A and cholangiocarcinoma.