Publication date: Available online 16 May 2019
Source: Annals of Diagnostic Pathology
Author(s): Mehmet Zengin
Abstract
Aim
Tumour-infiltrating T lymphocytes (TIL) are considered to be a reliable prognostic marker in CC, but the use in daily practice is unclear. We investigated the survival effect of TIL methodologically in a highly homogeneous population.
Methods
Seventy-two stage II CC patients who underwent surgical resection from 2002 to 2012 were included. CD3 and CD8 were separately scored for different blocks, areas and foci. To the best of our knowledge, this study has the most comprehensive methodology in the literature.
Results
Foremost, we searched the optimal evaluation method. We found better results with Model A (deepest invasive block&hot spot area&invasive margin focus), e.g. for CD3, the relationship with prognostic factors [advanced PT (p = 0.015), positive surgical margin (p = 0.019), MSI (p = 0.003), advanced grade (p = 0.015)], the correlation of distinct estimates (r = 0.708), the reproducibility of research (Κappa = 0.60–0.71), and the usefulness of cut-off value (area of under ROC = 0.800 [0.683–0.917]) were best. Then, survival analysis was performed with two beter methods including Model A. In univariate analysis, low TIL with Model A was associated with worse OS (CD3, p < 0.001; CD8, p = 0.023) and RFS (CD3, p < 0.001; CD8, p = 0.005). Multivariate analyzes confirmed low TIL with same method as an independent worse prognostic marker for OS (CD3, Hazard ratio [HR] = 1.42 [1.10–1.85], p = 0.005) and RFS (CD3, HR = 1.46 [1.17–1.83], p = 0.001; CD8, HR = 1.32 [1.05–1.64], p = 0.032).
Conclusions
Our results confirm that low TIL is an independent worse prognostic marker in stage II CC, and that the use of CD3 with Model A can contribute to improving the prognostication of early CCs.
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