Prognostic impact of lymphocytes in soft tissue sarcomas.
Prognostic impact of lymphocytes in soft tissue sarcomas.
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DOI：
10.1371/journal.pone.0014611
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发表时间：
2011-01-27
期刊：
影响因子：
3.7
通讯作者：
Busund LT
中科院分区：
文献类型：
--
作者：
Sorbye SW;Kilvaer T;Valkov A;Donnem T;Smeland E;Al-Shibli K;Bremnes RM;Busund LT
本研究的目的是阐明软组织肉瘤（STS）中淋巴细胞浸润的预后意义。潜在可治愈的 STS 的预后标志物应指导手术切除后的治疗。切除时的免疫状态可能很重要，但肿瘤浸润淋巴细胞的预后意义存在争议，因为免疫系统在癌症发展过程中发挥着相互冲突的作用。来自 249 名 STS 患者的组织微阵列是由存活且具有代表性的肿瘤区域的重复核心构建的。免疫组织化学用于评估肿瘤中的CD3+、CD4+、CD8+、CD20+和CD45+淋巴细胞。在单变量分析中，肿瘤中 CD4+ (P = 0.008) 和 CD20+ (P = 0.006) 淋巴细胞数量的增加与宽切缘患者 (n = 108) 的疾病特异性生存 (DSS) 改善显着相关。在非宽切缘患者 (n = 141) 中，肿瘤中 CD3+ (P = 0.028) 淋巴细胞数量的增加与较短的 DSS 显着相关。在多变量分析中，肿瘤中大量 CD20+ 淋巴细胞（HR = 5.5，CI 95% = 1.6–18.6，P = 0.006）是宽切缘患者 DSS 的独立阳性预后因素。切除边缘较宽的 STS 中高密度的 CD20+ 淋巴细胞是这些患者的独立阳性预后指标。需要进一步的研究来确定 CD20+ 细胞是否可以以减少疾病进展和转移潜力的方式改变肿瘤。
The purpose of this study was to clarify the prognostic significance of lymphocyte infiltration in soft tissue sarcomas (STS). Prognostic markers in potentially curable STS should guide therapy after surgical resection. The immune status at the time of resection may be important, but the prognostic significance of tumor infiltrating lymphocytes is controversial as the immune system has conflicting roles during cancer development. Tissue microarrays from 249 patients with STS were constructed from duplicate cores of viable and representative neoplastic tumor areas. Immunohistochemistry was used to evaluate the CD3+, CD4+, CD8+, CD20+ and CD45+ lymphocytes in tumors. In univariate analyses, increased numbers of CD4+ (P = 0.008) and CD20+ (P = 0.006) lymphocytes in tumor correlated significantly with an improved disease-specific survival (DSS) in patients with wide resection margins (n = 108). In patients with non-wide resection margins (n = 141) increased numbers of CD3+ (P = 0.028) lymphocytes in tumor correlated significantly with shorter DSS. In multivariate analyses, a high number of CD20+ lymphocytes (HR = 5.5, CI 95% = 1.6–18.6, P = 0.006) in the tumor was an independent positive prognostic factor for DSS in patients with wide resections margins. High density of CD20+ lymphocytes in STS with wide resection margins is an independent positive prognostic indicator for these patients. Further research is needed to define if CD20+ cells can modify tumors in a way that reduces disease progression and metastatic potential.
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