Wahlin Björn Engelbrekt, Sander Birgitta, Christensson Birger, Kimby Eva
Division of Hematology, Department of Internal Medicine at Huddinge, Karolinska Institutet, Karolinska University Hospital, 141 86 Stockholm, Sweden.
Clin Cancer Res. 2007 Jan 15;13(2 Pt 1):388-97. doi: 10.1158/1078-0432.CCR-06-1734.
Follicular lymphoma is a heterogeneous disease with variable prognosis and clinical course. We hypothesized that the presence of nonmalignant T cells in the microenvironment of the tumor may affect the outcome.
Using flow cytometry, we evaluated the T-cell subsets in the lymph node microenvironment of follicular lymphoma. All patients in South Stockholm County with indolent follicular lymphoma and with flow cytometry done on a diagnostic lymph node between 1994 and 2004 were included (N = 139). Diagnosis and grade (1, 2, and 3a) were confirmed by re-review. Flow cytometry results were reanalyzed. Lymphocyte subsets, the Follicular Lymphoma International Prognostic Index, grade, and clinical characteristics were evaluated in univariable and multivariable Cox analysis with respect to overall survival (OS) and disease-specific survival (DSS).
Higher CD8+ T-cell levels correlated with longer OS and DSS, independently of the Follicular Lymphoma International Prognostic Index (OS, P = 0.017; DSS, P = 0.020) and independently of all other prognostic factors (OS, P = 0.001; DSS, P = 0.004). Median OS was not reached for patients in the upper quarter of CD8+ T-cell levels (>8.6%), 10.4 years for patients in the middle half (4.2-8.6%), and 6.0 years for patients in the lower quarter (<4.2%). Furthermore, patients who had not required treatment within 6 months from diagnosis had more CD8+ T cells (P = 0.011).
Higher levels of CD8+ T cells predict a better prognosis, and these data support an important role for nonmalignant immune cells in the biology of follicular lymphoma. Evaluating the CD8+ T cells by flow cytometry at diagnosis may provide prognostic information.
滤泡性淋巴瘤是一种异质性疾病，预后和临床病程各不相同。我们推测肿瘤微环境中存在的非恶性T细胞可能会影响预后。
我们使用流式细胞术评估滤泡性淋巴瘤淋巴结微环境中的T细胞亚群。纳入了1994年至2004年间在南斯德哥尔摩县患有惰性滤泡性淋巴瘤且对诊断性淋巴结进行了流式细胞术检测的所有患者（N = 139）。通过重新评估确认诊断和分级（1、2和3a级）。对流式细胞术结果进行重新分析。在单变量和多变量Cox分析中，评估淋巴细胞亚群、滤泡性淋巴瘤国际预后指数、分级和临床特征与总生存期（OS）和疾病特异性生存期（DSS）的关系。
较高水平的CD8 + T细胞与更长的OS和DSS相关，独立于滤泡性淋巴瘤国际预后指数（OS，P = 0.017；DSS，P = 0.020），且独立于所有其他预后因素（OS，P = 0.001；DSS，P = 0.004）。CD8 + T细胞水平处于上四分位数（>8.6%）的患者未达到中位OS，处于中间半数（4.2 - 8.6%）的患者为10.4年，处于下四分位数（<4.2%）的患者为6.0年。此外，诊断后6个月内未接受治疗的患者CD8 + T细胞更多（P = 0.011）。
较高水平的CD8 + T细胞预示着更好的预后，这些数据支持非恶性免疫细胞在滤泡性淋巴瘤生物学中发挥重要作用。诊断时通过流式细胞术评估CD8 + T细胞可能提供预后信息。
