CD8+ lymphocyte intratumoral infiltration as a stage-independent predictor of Merkel cell carcinoma survival: a population-based study.
CD8+ lymphocyte intratumoral infiltration as a stage-independent predictor of Merkel cell carcinoma survival: a population-based study.
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DOI：
10.1309/ajcpikdzm39crpnc
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发表时间：
2014-10
影响因子：
3.5
通讯作者：
Nghiem P
中科院分区：
文献类型：
--
作者：
Paulson KG;Iyer JG;Simonson WT;Blom A;Thibodeau RM;Schmidt M;Pietromonaco S;Sokil M;Warton EM;Asgari MM;Nghiem P
肿瘤内CD 8+淋巴细胞（IT-CD 8）作为默克尔细胞癌（MCC）的预后指标已显示出前景。我们测试了IT-CD 8是否可以预测基于人群的MCC队列的生存率。研究了137例以前未分析IT-CD 8的MCC病例。IT-CD 8 s缺失（n = 46）、低水平（n = 85）和中度或强水平（n = 6）患者的3年MCC特异性生存率分别为56%、72%和100%。在包括分期、年龄和性别的多变量竞争风险回归分析中，IT-CD 8增加与MCC特异性生存率改善相关（风险比[HR] = 0.5; 95%置信区间[CI] = 0.3-0.9）。虽然观察到总生存期的相似趋势，但未达到统计学显著性（HR = 0.8; 95% CI = 0.6-1.0），可能是因为老年患者中非MCC死亡率较高。这项前瞻性MCC病例研究支持细胞免疫在MCC结局中很重要的概念，CD 8+淋巴细胞浸润为传统分期提供了预后信息。
Intratumoral CD8+ lymphocytes (IT-CD8s) have shown promise as a prognostic indicator for Merkel cell carcinoma (MCC). We tested whether IT-CD8s predict survival among a population-based MCC cohort. One hundred thirty-seven MCC cases that had not previously been analyzed for IT-CD8s were studied. Three-year MCC-specific survival rates were 56%, 72%, and 100% for patients with absent (n = 46), low (n = 85), and moderate or strong (n = 6) IT-CD8s, respectively. Increased IT-CD8s were associated with improved MCC-specific survival in a multivariate competing risk-regression analysis including stage, age, and sex (hazards ratio [HR] = 0.5; 95% confidence interval [CI] = 0.3-0.9). Although a similar trend was observed for overall survival, statistical significance was not reached (HR = 0.8; 95% CI = 0.6-1.0), likely because of the high rate of non-MCC deaths among older patients. This study of prospectively captured MCC cases supports the concept that cellular immunity is important in MCC outcome and that CD8+ lymphocyte infiltration adds prognostic information to conventional staging.