Prognostic impact of lymphocytes in soft tissue sarcomas

• Published in: PloS one 2011-01, Vol.6 (1), p.e14611-e14611
• Main Authors: Sorbye, Sveinung W, Kilvaer, Thomas, Valkov, Andrej, Donnem, Tom, Smeland, Eivind, Al-Shibli, Khalid, Bremnes, Roy M, Busund, Lill-Tove
• Format: Article
• Language: English
• Subjects: Antigens; Antigens, CD - analysis; Antigens, CD20; B cells; Biology; Biomarkers, Tumor - analysis; Cancer; CD20 antigen; CD3 antigen; CD4 antigen; CD4-Positive T-Lymphocytes - pathology; CD45 antigen; CD8 antigen; Cell cycle; Cell survival; Clinical medical disciplines: 750; Clinical medicine; Cores; Esophagus; Experimental design; Flow cytometry; Glycoproteins; Head & neck cancer; Hospitals; Humans; Immune status; Immune system; Immunohistochemistry; Infiltration; Klinisk medisinske fag: 750; Lung cancer; Lymphatic system; Lymphocyte Count; Lymphocytes; Lymphocytes, Tumor-Infiltrating - pathology; Lymphoma; Medical disciplines: 700; Medical prognosis; Medisinske Fag: 700; Melanoma; Metastases; Metastasis; Multivariate analysis; Oncology; Oncology/Sarcomas; Oncology: 762; Onkologi: 762; Ovarian cancer; Pathology; Pathology/Histopathology; Pathology/Immunology; Pathology/Molecular Pathology; Pathology/Surgical Pathology; Patients; Prognosis; Proteins; Sarcoma; Sarcoma - diagnosis; Sarcoma - pathology; Surgery; T cell receptors; Tissue Array Analysis; Tissues; Tumors; VDP
• ISSN: 1932-6203; 1932-6203
• 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.