Sorbye Sveinung W, Kilvaer Thomas K, Valkov Andrej, Donnem Tom, Smeland Eivind, Al-Shibli Khalid, Bremnes Roy M, Busund Lill-Tove
Dept of Clinical Pathology, University Hospital of North Norway, 9038 Tromso, Norway.
BMC Clin Pathol. 2012 Feb 29;12:5. doi: 10.1186/1472-6890-12-5.
The purpose of this study was to clarify the prognostic significance of peritumoral lymphocyte infiltration in the capsule of soft tissue sarcomas (STS). Multiple observations in preclinical and clinical studies have shown that the immune system has a role in controlling tumor growth and progression. 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 peritumoral lymphocytes is unknown.
Tissue microarrays from 80 patients with STS were constructed from duplicate cores of tissue from the tumor and the peritumoral capsule. Immunohistochemistry was used to evaluate the CD3+, CD4+, CD8+ and CD20+ lymphocytes in the tumor and the peritumoral capsule.
In univariate analyses, increasing numbers of CD20+ (P = 0.032) peritumoral lymphocytes were associated with a reduced disease free survival (DSS). In multivariate analyses, a high number of CD20+ peritumoral lymphocytes (P = 0.030) in the capsule was an independent negative prognostic factor for DSS. There were no such associations of lymphocyte infiltration in the tumor.
A high density of CD20+ peritumoral lymphocytes is an independent negative prognostic indicator for patients with STS. Further research is needed to determine whether CD20 cells in the peritumoral capsule of STS may promote tumor invasion in the surrounding tissue and increase the metastatic potential.
本研究的目的是阐明软组织肉瘤（STS）包膜内瘤周淋巴细胞浸润的预后意义。临床前和临床研究中的多项观察表明，免疫系统在控制肿瘤生长和进展中发挥作用。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，但瘤周淋巴细胞的预后意义尚不清楚。
从80例STS患者的肿瘤和瘤周包膜组织的重复芯块构建组织微阵列。免疫组织化学用于评估肿瘤和瘤周包膜中的CD3 +、CD4 +、CD8 +和CD20 +淋巴细胞。
在单变量分析中，瘤周CD20 +淋巴细胞数量增加（P = 0.032）与无病生存期（DSS）降低相关。在多变量分析中，包膜中大量CD20 +瘤周淋巴细胞（P = 0.030）是DSS的独立阴性预后因素。肿瘤中的淋巴细胞浸润无此类关联。
高密度的CD20 +瘤周淋巴细胞是STS患者的独立阴性预后指标。需要进一步研究以确定STS瘤周包膜中的CD20细胞是否可能促进肿瘤向周围组织的侵袭并增加转移潜能。
