Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany.
Department of Pathology, Friedrich-Alexander-University, Krankenhausstraße 8-10, 91054 Erlangen, Germany.
Int J Mol Sci. 2020 Mar 5;21(5):1779. doi: 10.3390/ijms21051779.
Patients with pancreatic ductal adenocarcinoma (PDAC) normally have a poor long-term prognosis. However, some rare cases of long-term survivors have been reported. The tumor microenvironment, consisting of cellular and stromal components, possibly plays an important role and might influence prognosis. In this context, the role of tumor-infiltrating B-cells and its impact on the survival in patients with PDAC remains controversial. We therefore aimed to assess the prognostic value of CD20-positive B-cells and CD20-positive B-cell aggregates as well as CD138, IgM, Pax5, and Ki67 on the survival of patients with PDAC using immunohistochemistry of FFPE pancreatectomy tissue sections from patients that underwent primary surgery for pT3- and R0-pancreatic adenocarcinoma between 1995 and 2016. Patients with PDAC were matched and grouped in 16 long-term-survivors (LTS, median overall survival (OS): 96 months [range: 61-177 months]) and 16 short-term-survivors (STS, median OS: 16 months [range: 7-32 months]). CD20-positive B-cells and B-cell aggregates in the tumor infiltration zone were significantly upregulated in the LTS-group compared to the STS-group ( = 0.0499 respectively = 0.0432). Regarding the entire patient cohort ( = 32) CD20 positive B-cell aggregates in the tumor infiltration zone were an independent prognostic marker for overall survival in multivariate analysis (HR 9.2, CI 1.6-51.4, = 0.012). These results underline the importance of tumor-associated B-cells for prognosis of patients with PDAC. The detailed role of B cells in the pathomechanism of PDAC should be further investigated for predicting outcome, identifying appropriate treatment regimens, and developing novel therapeutic options.
患有胰腺导管腺癌 (PDAC) 的患者通常预后较差。然而,已有报道称一些罕见的长期生存病例。肿瘤微环境由细胞和基质成分组成,可能发挥着重要作用,并可能影响预后。在这种情况下,肿瘤浸润 B 细胞的作用及其对 PDAC 患者生存的影响仍然存在争议。因此,我们旨在使用免疫组化方法评估 CD20 阳性 B 细胞和 CD20 阳性 B 细胞聚集体以及 CD138、IgM、Pax5 和 Ki67 在 1995 年至 2016 年间接受原发性 pT3 和 R0 胰腺腺癌手术的患者的 FFPE 胰腺切除术组织切片中的预后价值。将 PDAC 患者匹配并分为 16 名长期幸存者 (LTS,中位总生存期 (OS):96 个月 [范围:61-177 个月]) 和 16 名短期幸存者 (STS,中位 OS:16 个月 [范围:7-32 个月])。与 STS 组相比,肿瘤浸润区的 CD20 阳性 B 细胞和 B 细胞聚集体在 LTS 组中显著上调 (=0.0499 分别=0.0432)。在整个患者队列中 (=32),肿瘤浸润区的 CD20 阳性 B 细胞聚集体在多变量分析中是总生存期的独立预后标志物 (HR 9.2,CI 1.6-51.4,=0.012)。这些结果强调了肿瘤相关 B 细胞对 PDAC 患者预后的重要性。B 细胞在 PDAC 发病机制中的详细作用应进一步研究,以预测结果、确定适当的治疗方案和开发新的治疗选择。