Density and location of CD3(+) and CD8(+) tumor-infiltrating lymphocytes correlate with prognosis of oral squamous cell carcinoma.

Tumor-infiltrating lymphocytes (TILs) are regarded as adaptive immune response of the host to cancer cells and valuable prognostic factors. Here, we sought to characterize the densities and locations of CD3+ and CD8+ TILs in primary oral squamous cell carcinoma (OSCC) samples and assess their clinicopathological and prognostic significance. A total number of 169 OSCC samples from 2 independent patient cohorts (Nanjing cohort, 93 cases; Wuxi cohort, 76 cases) were retrospectively collected. The numbers of CD3+ and CD8+ TILs at tumor center (CT) and invasive margin (IM) of OSCC were identified by immunohistochemistry and calculated. The optimal cutoff values for CD3+ and CD8+ TILs to stratify patients were determined by X-tile software in Nanjing cohort and further utilized in Wuxi cohort. The associations between CD3+ /CD8+ TILs and clinicopathological parameters or patient survival were assessed. The prognostic values of CD3+ / CD8+ TILs were evaluated by Cox regression analyses. CD3+ and CD8+ TILs were identified at both CT and IM and enriched at IM. High density of CD3+ TILs at IM (CD3 IM) was significantly associated with increased overall and disease-specific survival (P < .05). High density of CD8+ TILs at CT (CD8 CT) was significantly associated with increased overall but not disease-specific survival. Moreover, CD3 IM and CD8 CT were identified as independent prognostic factors for patient survival. Our findings provide further evidence to support the prognostic values of CD3+ and CD8+ TILs for OSCC, suggesting that TIL subsets might be viable biomarkers and therapeutic targets with translational significance.

Zhou C ，Wu Y ，Jiang L ，Li Z ，Diao P ，Wang D ，Zhang W ，Liu L ，Wang Y ，Jiang H ，Cheng J ，Yang J ... -  《-》

High Density of Intratumor CD45RO(+) Memory Tumor-Infiltrating Lymphocytes Predicts Favorable Prognosis in Patients With Oral Squamous Cell Carcinoma.

Although tumor-infiltrating lymphocytes (TILs) have been increasingly appreciated as novel biomarkers for prognostic prediction in cancer, little attention has been paid to the CD45RO+ memory TIL and its associations with clinical outcomes in oral squamous cell carcinoma (OSCC). The purpose of this study was to determine the associations between CD45RO+ TILs and clinicopathologic parameters and prognosis in OSCC. Tissue sections of primary OSCC from 2 independent tertiary referral cancer centers (Nanjing and Wuxi, China) were retrospectively collected and subjected to immunohistochemical staining for CD45RO. Densities of CD45RO+ TILs in the tumor center (CT) and invasive margin were calculated. Optimal cutoff values of CD45RO+ TILs for patient stratification were generated by X-tile software. Kaplan-Meier and Cox regression analyses were performed to assess associations between CD45RO+ TILs and overall survival and recurrence-free survival. Prognostic prediction of CD45RO+ TILs was estimated by receiver operating characteristic (ROC) curve. One hundred sixty-nine eligible patients with OSCC were included. No relevant associations between CD45RO+ TILs and clinicopathologic parameters were identified. Kaplan-Meier analyses indicated that a high density of CD45RO TILs in the CT was significantly associated with favorable overall and recurrence-free survival (P = .0018 and .0007 by log-rank test). Cox proportional regression analyses showed that presence of CD45RO TILs in the CT was an independent prognostic factor for overall survival of OSCC. ROC curves showed that presence of CD45RO TILs in the CT was comparable to clinical stage in predicting patient survival, whereas their combination was superior to either parameter alone. The present findings indicate that intratumor density of CD45RO TILs is a viable and independent prognostic predictor for OSCC.

Zhou C ，Li J ，Wu Y ，Diao P ，Yang J ，Cheng J ... -  《-》

Prognostic Role of Tumor-Infiltrating Lymphocytes in Oral Squamous Cell Carcinoma.

In oral squamous cell carcinoma (OSCC), the tumor-node-metastasis (TNM) staging system is a significant factor that influences prognosis and treatment decisions for OSCC patients. Unfortunately, TNM staging does not consistently predict patient prognosis and patients with identical clinicopathological characteristics may have vastly different survival outcomes. Host immunity plays an important role in tumor progression but is not included in the TNM staging system. Tumor-infiltrating lymphocytes (TILs) are part of the host immune response that recognizes tumor cells; and the presence of TILs has emerged as potential candidates for prognostic markers for many types of cancers. The present study aims to determine the association of T cell-specific markers (CD3, CD4, CD8, and FOXP3) with clinicopathological characteristics and survival outcomes in OSCC patients. The prognostic value of CD3, CD4, and CD8 will also be evaluated based on tumor stage. Tissue microarrays were constructed containing 231 OSCC cases and analyzed by immunohistochemical staining for the expression of CD3, CD4, CD8, and FOXP3. The expression scores for each marker were correlated with clinicopathological parameters and survival outcomes. The prognostic impact of CD3, CD4 and CD8 were further analyzed based on tumor stage (early or advanced). CD3, CD4, and CD8 were found to be significantly associated with both overall survival and progression-free survival using univariate analysis. However, none of these markers were found to independently predict the survival outcomes of OSCC using multivariate analysis. Only conventional factors such as nodal status, tumor differentiation and perineural invasion (PNI) were independent predictors of survival outcomes, with nodal status being the strongest independent predictor. Additionally, low CD4 (but not CD3 or CD8) expression was found to identify early-stage OSCC patients with exceptionally poor prognosis which was similar to that of advanced staged OSCC patients. TIL markers such as CD3, CD4, CD8, and FOXP3 can predict the survival outcomes of OSCC patients, but do not serve as independent prognostic markers as found with conventional factors (i.e. nodal status, tumor differentiation and PNI). CD4 expression may assist with risk stratification in early-stage OSCC patients which may influence treatment planning and decision making for early-stage OSCC patients.

Wongpattaraworakul W ，Choi A ，Buchakjian MR ，Lanzel EA ，Kd AR ，Simons AL ... -  《BMC CANCER》

Prognostic markers in oropharyngeal squamous cell carcinoma: focus on CD70 and tumour infiltrating lymphocytes.

We evaluated the expression of CD70 as biomarker for prognosis in patients with oropharyngeal squamous cell carcinoma (OSCC). We also examined the prognostic value of tumour infiltrating lymphocytes (TILs) in our study cohort. Formalin fixed, paraffin embedded tissue originating from the oropharynx of 78 patients was immunohistochemically stained for CD70, CD3, CD8 and FoxP3. Expression of CD70, CD3, CD8, FoxP3 and HPV status was correlated with clinicopathological characteristics. Overall survival (OS) was determined by a log-rank (Mantel-Cox) test whereas the Cox proportional hazard model was used for multivariate analysis. CD70 expression demonstrated no influence on OS. Tumours heavily infiltrated by TILs were linked with better outcome, for the total number of TILs as well as for the CD3+ and CD8+ T cell count. A Cox proportional hazard model proved that solely CD8+ infiltrating T cells exhibit a positive effect on OS (HR=0.30, 95% confidence interval 0.13-0.72). Our results demonstrate that CD8+ TILs constitute an independent prognosticator in patients diagnosed with OSCC. Further validation of the prognostic value of CD8+ TILs in OSCC is warranted and could provide us with a better insight into the immunological status of these malignancies.

De Meulenaere A ，Vermassen T ，Aspeslagh S ，Zwaenepoel K ，Deron P ，Duprez F ，Rottey S ，Ferdinande L ... -  《-》

Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma.

Fang J ，Li X ，Ma D ，Liu X ，Chen Y ，Wang Y ，Lui VWY ，Xia J ，Cheng B ，Wang Z ... -  《BMC CANCER》