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. 2016 Jul;38(7):1074-84.
doi: 10.1002/hed.24406. Epub 2016 Feb 16.

Tumor infiltrating lymphocytes and survival in patients with head and neck squamous cell carcinoma

Nghia Nguyen  1 , Emily Bellile  2 , Daffyd Thomas  3 , Jonathan McHugh  3 , Laura Rozek  4 , Shama Virani  4 , Lisa Peterson  1 , Thomas E Carey  1 , Heather Walline  1 , Jeffery Moyer  1 , Matthew Spector  1 , Daniel Perim  5 , Mark Prince  1 , Scott McLean  1 , Carol R Bradford  1 , Jeremy M G Taylor  2 , Gregory T Wolf  1 ; Head and Neck SPORE Program Investigators
Affiliations

Tumor infiltrating lymphocytes and survival in patients with head and neck squamous cell carcinoma

Nghia Nguyen et al. Head Neck. 2016 Jul.

Abstract

Background: Because immune responses within the tumor microenvironment are important predictors of tumor biology, correlations of types of tumor infiltrating lymphocytes (TILs) with clinical outcomes were determined in 278 patients with head and neck squamous cell carcinoma (HNSCC).

Methods: Infiltrating levels of CD4 (helper T cells), CD8 (cytotoxic/suppressor T cells), FoxP3 (regulatory T cells), CD68 (myeloid-derived suppressor cells,) and CD1a (Langerhans) cells were measured in tissue microarrays (TMAs). Cox models tested associations with patient outcomes after adjusting for all known prognostic factors. Median follow-up was 36.6 months.

Results: Higher CD4 and CD8 TIL levels were associated with improved overall survival (OS; hazard ratio [HR] = 0.77; 95% confidence interval [CI] = 0.65-0.93; p = .005 and HR = 0.77; 95% CI = 0.64-0.94; p = .008, respectively), and relapse-free survival (RFS; p = .03 and .05, respectively). After controlling for prognostic factors, higher CD4 levels predicted improved OS and disease-specific survival (DSS; p = .003 and p = .004, respectively).

Conclusion: The findings suggest that TILs are a significant independent prognostic factor for HNSCC that differ by treatment. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1074-1084, 2016.

Keywords: cancer; prognosis; tumor infiltrating lymphocytes.

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Figures

Figure 1
Figure 1
Kaplan-Meier survival curves for overall, recurrence free and disease specific survival according to lymphocyte subset levels above (high) or below (low) the median value. Significant differences (log-rank testing) were found in all outcomes for CD4 and CD8 infiltrate levels. FoxP3 levels were also significant for overall survival.
Figure 2
Figure 2
Kaplan-Meier curves for overall survival for above (high) or below (low) the median value within treatment type of of tumor infiltrating lymphocyte subset levels according to primary treatment modality. Surgery patient survival illustrated in upper panels and chemoradiation patient survival illustrated in lower panels. Among surgical patients, high levels of CD8 cells were significant for prognosis (log-rank testing) while for chemoradiation patients, high levels of CD4, CD8 and FoxP3 T-cell infiltrates were significant (log-rank testing). Low and high strata were defined separately for surgery and chemoradiation modality cohorts by median cutoff within treatment set.
See this image and copyright information in PMC

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