Department of Otolaryngology-Head and Neck Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA.
Otolaryngol Head Neck Surg. 2023 Sep;169(3):539-547. doi: 10.1002/ohn.249. Epub 2023 Jan 30.
We aim to explore the prognostic value of tumor-infiltrating lymphocytes (TILs) in the primary tumor and metastatic lymph nodes of patients with HPV(+)OPSCC. We hypothesize that TILS density at both sites is associated with disease-free survival in HPV(+)OPSCC.
Matched case-control study among HPV(+)OPSCC patients who underwent intent-to-cure surgery. Cases developed locoregional or distant recurrence. Controls were matched based on age, sex, pathologic T, N, and overall stage, year of surgery, type of adjuvant treatment received, and the Adult Comorbidity Evaluation-27 (ACE-27) score.
Single tertiary care center, May 2007 to December 2016.
Tumoral TILs (tTILs) density was defined as % TILs; stromal TILs (sTILs) density was defined as absent/sparse or moderate/dense crowding. Associations between TILs and time to disease progression were assessed using Cox regression models.
Forty-four case-control pairs (N = 88) were included: 42 (48%) AJCC pStage I, 39 (44%) pStage II, and 7 (8%) pStage III. tTILs density ≥10% (hazard ratio [HR] 0.41, 95% confidence interval [CI] 0.17-0.99, p = .048) and a moderate/dense sTILs density (HR 0.21, 95% CI 0.06-0.75, p = .016) in the primary tumor were significantly associated with decreased risk of progression. TILs density in the lymph node was associated with decreased risk of progression but did not reach statistical significance. The tTILs and sTILs density correlated strongly between the primary tumor and lymph node. Concordance between the pathologists' was moderate (60%-70%).
In HPV(+)OPSCC, a higher density of tumoral and stromal TILs in the primary tumor and possibly the lymph node may predict a lower risk of disease progression.
我们旨在探索 HPV(+)OPSCC 患者原发肿瘤和转移性淋巴结中肿瘤浸润淋巴细胞（TILs）的预后价值。我们假设这两个部位的 TILS 密度与 HPV(+)OPSCC 的无病生存率相关。
对接受根治性手术的 HPV(+)OPSCC 患者进行配对病例对照研究。病例组发生局部区域或远处复发。对照组基于年龄、性别、病理 T、N 和总分期、手术年份、接受的辅助治疗类型以及成人合并症评估-27（ACE-27）评分进行匹配。
单中心三级保健中心，2007 年 5 月至 2016 年 12 月。
肿瘤内 TILs（tTILs）密度定义为 %TILs；间质 TILs（sTILs）密度定义为无/稀疏或中度/密集拥挤。使用 Cox 回归模型评估 TILs 与疾病进展时间之间的关联。
纳入了 44 对病例对照（N=88）：42 例（48%）AJCC pStage I、39 例（44%）pStage II 和 7 例（8%）pStage III。原发肿瘤中 tTILs 密度≥10%（危险比[HR]0.41，95%置信区间[CI]0.17-0.99，p=0.048）和中度/密集 sTILs 密度（HR 0.21，95%CI 0.06-0.75，p=0.016）与进展风险降低显著相关。淋巴结中 TILs 密度与进展风险降低相关，但未达到统计学意义。原发肿瘤和淋巴结之间的 TILs 密度相关性很强。病理学家之间的一致性为中等（60%-70%）。
在 HPV(+)OPSCC 中，原发肿瘤和淋巴结中肿瘤和间质 TILs 密度较高可能预示疾病进展风险较低。
