Echarti Alessia, Hecht Markus, Büttner-Herold Maike, Haderlein Marlen, Hartmann Arndt, Fietkau Rainer, Distel Luitpold
Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91054 Erlangen, Germany.
Department of Nephropathology, Institute of Pathology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, D-91054 Erlangen, Germany.
Cancers (Basel). 2019 Sep 19;11(9):1398. doi: 10.3390/cancers11091398.
The tumor immune status "inflamed", "immune excluded", and "desert" might serve as a predictive parameter. We studied these three cancer immune phenotypes while using a simple immunohistochemical algorithm.
Pre-treatment tissue samples of 280 patients with locally advanced HNSCC treated with radiochemotherapy were analyzed. A double staining of CD8+ cytotoxic T cells (CTL) and FoxP3+ (Treg) was performed and the cell density was evaluated in the intraepithelial and stromal compartment of the tumor.
The classification of tumors as "immune desert" when stromal CTL were ≤ 50 cells/mm, "inflamed" when intraepithelial CTL were > 500 cells/mm, and as "excluded" when neither of these definitions met these cut off values allowed the best discrimination regarding overall survival. These groups had median OS periods of 37, 61, and 85 months, respectively. In "immune desert" and "immune excluded" tumors high Treg tended to worsen OS, but in "inflamed" tumors high Treg clearly improved OS.
We propose that, in locally advanced HNSCC, the tumor immune state "inflamed", "immune excluded", and "immune desert" can be defined by intraepithelial and stromal CTL. Tregs can further subdivide these groups. The opposing effects of Tregs in the different groups might be the reason for the inconsistency of Tregs prognostic values published earlier.
肿瘤免疫状态“炎症性”“免疫排除性”和“无反应性”可作为预测参数。我们使用一种简单的免疫组织化学算法研究了这三种癌症免疫表型。
分析了280例接受放化疗的局部晚期头颈部鳞状细胞癌患者的治疗前组织样本。对CD8 + 细胞毒性T细胞（CTL）和FoxP3 +（调节性T细胞）进行双重染色，并评估肿瘤上皮内和基质区室中的细胞密度。
当基质CTL≤50个细胞/mm时，肿瘤分类为“免疫无反应性”；当上皮内CTL>500个细胞/mm时，分类为“炎症性”；当这些定义均未达到这些临界值时，分类为“排除性”，这对于总生存期具有最佳的区分度。这些组的中位总生存期分别为37、61和85个月。在“免疫无反应性”和“免疫排除性”肿瘤中，高调节性T细胞倾向于使总生存期恶化，但在“炎症性”肿瘤中，高调节性T细胞明显改善了总生存期。
我们提出，在局部晚期头颈部鳞状细胞癌中，肿瘤免疫状态“炎症性”“免疫排除性”和“免疫无反应性”可通过上皮内和基质CTL来定义。调节性T细胞可进一步细分这些组。调节性T细胞在不同组中的相反作用可能是早期发表的调节性T细胞预后价值不一致的原因。
