Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway.
PLoS One. 2011 Jan 27;6(1):e14611. doi: 10.1371/journal.pone.0014611.
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.
本研究旨在阐明淋巴细胞浸润在软组织肉瘤（STS）中的预后意义。在可治愈的潜在 STS 中，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具有矛盾的作用。
从 249 例 STS 患者的组织微阵列中构建了重复的可行和代表性肿瘤区域的核心。免疫组织化学用于评估肿瘤中的 CD3+、CD4+、CD8+、CD20+和 CD45+淋巴细胞。
在单因素分析中，肿瘤中 CD4+（P=0.008）和 CD20+（P=0.006）淋巴细胞数量的增加与广泛切除边缘（n=108）患者的疾病特异性生存率（DSS）显著相关。在非广泛切除边缘（n=141）的患者中，肿瘤中 CD3+（P=0.028）淋巴细胞数量的增加与 DSS 显著相关。在多因素分析中，肿瘤中大量 CD20+淋巴细胞（HR=5.5，95%CI 95%=1.6-18.6，P=0.006）是广泛切除边缘患者 DSS 的独立预后因素。
在广泛切除边缘的 STS 中，CD20+淋巴细胞的高密度是这些患者独立的阳性预后指标。需要进一步研究以确定 CD20+细胞是否可以以降低疾病进展和转移潜力的方式改变肿瘤。
