Prognostic value of Tumor-infiltrating lymphocytes in Epstein-Barr virus-associated gastric cancer
Menée à partir de données portant sur 120 patients atteints d'un cancer de l'estomac lié au virus d'Epstein-Barr, cette étude évalue l'association entre le pourcentage de lymphocytes infiltrant la tumeur et/ou son stroma et la survie des patients
Background : This study explored the prognostic impact of TILs and investigated whether three histologic subtypes (lymphoepithelioma-like carcinoma [LELC], carcinoma with Crohn's disease-like lymphoid reaction [CLR], and conventional-type adenocarcinoma [CA]) could stratify a prognostic subset for patients with EBVaGC.
Materials and methods : After reviewing 1318 consecutive cases of surgically resected or endoscopic submucosal dissected gastric cancers, 120 patients were identified as EBV-positive using EBV-encoded RNA in-situ hybridization. The evaluation of the percentage of intratumoral (iTu-) and stromal (str-) TIL was carried out, and the cases were also sub-classified into three histologic subtypes as noted above.
Results : Among the 120 patients, 73 patients (60.8%) and 60 patients (50.0%) were determined as str-TIL-positive and iTu-TIL-positive, respectively. In a univariate analysis, str-TIL-positivity was significantly associated with longer recurrence-free survival (RFS) (P=0.002) and disease-free survival (DFS) (P=0.008), yet not overall survival (OS) (P=0.145). While iTu-TIL-positivity has a tendency of favorable outcome indicator for DFS and OS, but statistically significant differences were not shown, respectively (RFS, P=0.058; DFS, P=0.151; OS, P=0.191). In a multivariate analysis using a Cox proportional hazard model adjusted for age, pTNM stage, lymphatic invasion, perineural invasion, and venous invasion, histologic subtype, WHO classification, str-TILs-positivity was independently or tentatively associated with favorable RFS (HR=12.193, 95% CI=1.039-143.055, P=0.047) or DFS (HR=4.836, 95% CI=0.917-25.525, P=0.063).
Conclusion : The histologic sub-classification and TILs can be used to predict RFS and DFS for patients with EBVaGC.
Annals of Oncology , résumé, 2015