Prognostic Significance of Tumor Immunity in Surgically Resected Pulmonary Pleomorphic Carcinoma
Prognostic Significance of Tumor Immunity in Surgically Resected Pulmonary Pleomorphic Carcinoma
复制标题
DOI：
10.21873/anticanres.13948
复制
发表时间：
2020-01-01
影响因子：
2
通讯作者：
Shirabe, Ken
中科院分区：
文献类型：
--
作者：
Kaira, Kyoichi;Shimizu, Kimihiro;Shirabe, Ken
背景：肺多形性癌是一种罕见的侵袭性肿瘤，预后差。肿瘤免疫是否与PPC的进行性生物学行为相关尚不清楚。本研究的目的是检查肿瘤免疫相关标志物，如程序性死亡-1配体（PD-L1）和CD 4（+）或CD 8（+）肿瘤浸润淋巴细胞（TIL）在手术切除的PPC患者中的预后意义。患者和方法：99例手术切除的PPC患者进行了免疫组化评估。在切除的肿瘤标本中检测PDL 1、CD 4和CD 8的表达。结果如下：PD-L1在61%（60/99）的病变中高表达，CD 4和CD 8分别在42%（42/99）和51%（51/99）的病变中高表达。PD-L1的表达与CD 4（+）、CD 8（+）TIL数量无关。PD-L1表达未被确定为显著的预后标志物;然而，低数量的CD 4（+）TIL被确定为预测PPC手术切除后预后更差的独立标志物，尤其是在腺癌上皮成分或疾病早期的患者中。通过单变量分析，发现低数量的CD 8（+）TIL是与非腺癌患者的总生存率差相关的重要预后标志物。结论：低数量的CD 4（+）TIL是预测PPC患者手术切除后良好预后的独立标志物，特别是在腺癌成分或疾病早期的患者中。
Background: Pulmonary pleomorphic carcinoma (PPC) is a rare aggressive neoplasm, with dismal prognosis. Whether tumor immunity is associated with the progressive biological behavior of PPC remains unclear. The purpose of this study was to examine the prognostic significance of tumor immunity-related markers such as programmed death-1 ligand (PD-L1) and CD4(+) or CD8(+) tumor-infiltrating lymphocytes (TILs) in patients with surgically resected PPC. Patients and Methods: Ninety-nine patients with surgically resected PPC were assessed by immunohistochemistry. The expression of PDL1, CD4, and CD8 was examined in specimens of the resected tumors. Results: PD-L1 was highly expressed in 61% (60/99) of lesions and high expression of CD4 and CD8 was identified in 42% (42/99) and 51% (51/99) of lesions, respectively. There was no relationship between the expression PD-L1 and the numbers of CD4(+) or CD8(+) TILs. The expression of PD-L1 was not identified as a significant prognostic marker; however, a low number of CD4(+) TILs was identified as an independent marker for predicting a worse outcome after surgical resection of PPC, especially in patients with an epithelial component of adenocarcinoma or early stage of disease. By univariate analysis, a low number of CD8(+) TILs was found to be a significant prognostic marker linked to poor overall survival in patients with non-adenocarcinoma components. Conclusion: A low number of CD4(+) TILs is an independent marker for predicting a favorable prognosis after surgical resection in patients with PPC, especially in patients with adenocarcinoma components or early stage of disease.