Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology

Background Tumor-infiltrating lymphocytes have been reported as prognostic markers in tumors. We aimed to assess the prognostic value of total T cell (CD3+) density, cytotoxic T cell (CD8+) density and memory T cell (CD45RO+) density in patients with nasopharyngeal carcinoma (NPC).Methods The expres...

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Main Authors: Na Liu, Lei Chen, Wei Jiang, Yu Zhang, Yu-Pei Chen, Ya-Qin Wang, Yan-Ping Mao, Ying-Qing Li, Shuo-Yu Xu, Xiao-Min Li, Qing-Mei He, Shi-Wei He, Xiao-Jing Yang, Yuan Lei, Yin Zhao, Jing-Ping Yun, Yingqin Li
Format: Article
Language:English
Published: BMJ Publishing Group 2020-10-01
Series:Journal for ImmunoTherapy of Cancer
Online Access:https://jitc.bmj.com/content/8/2/e000334.full
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author Na Liu
Lei Chen
Wei Jiang
Yu Zhang
Yu-Pei Chen
Ya-Qin Wang
Yan-Ping Mao
Ying-Qing Li
Shuo-Yu Xu
Xiao-Min Li
Qing-Mei He
Shi-Wei He
Xiao-Jing Yang
Yuan Lei
Yin Zhao
Jing-Ping Yun
Yingqin Li
author_facet Na Liu
Lei Chen
Wei Jiang
Yu Zhang
Yu-Pei Chen
Ya-Qin Wang
Yan-Ping Mao
Ying-Qing Li
Shuo-Yu Xu
Xiao-Min Li
Qing-Mei He
Shi-Wei He
Xiao-Jing Yang
Yuan Lei
Yin Zhao
Jing-Ping Yun
Yingqin Li
author_sort Na Liu
collection DOAJ
description Background Tumor-infiltrating lymphocytes have been reported as prognostic markers in tumors. We aimed to assess the prognostic value of total T cell (CD3+) density, cytotoxic T cell (CD8+) density and memory T cell (CD45RO+) density in patients with nasopharyngeal carcinoma (NPC).Methods The expression of CD3, CD8 and CD45RO was detected by immunohistochemistry in the training (n=221) and validation cohorts (n=115). The densities of these three markers were quantified by digital pathology both in the tumor and stroma. Then, we developed the immune score based on the density of these three markers and further analyzed its prognostic value.Results The high density of CD3+, CD8+ and CD45RO+ T cells both in the tumor and/or stroma were significantly associated with the decrease in mortality in the training cohort, respectively. High immune score predicted a prolonged overall survival (OS) (HR 0.34, 95% CI 0.18 to 0.64, p=0.001, disease-free survival (DFS) (HR 0.44, 95% CI 0.25 to 0.78, p=0.005) and distant metastasis-free survival (DMFS) (HR 0.43, 95% CI 0.21 to 0.87, p=0.018) in NPC patients. The findings were confirmed in the validation cohort. Multivariate analysis revealed that immune score remained an independent prognostic indicator for OS, DFS and DMFS. In addition, we established a nomogram with the integration of all independent variables to predict individual risk of death.Conclusions We established an immune score model, which provides a reliable estimate of the risk of death, disease progress and distant metastasis in NPC patients.
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spelling doaj-art-0f6f4b4b8cba49b7b26f37f3ad1aabae2024-11-09T21:40:09ZengBMJ Publishing GroupJournal for ImmunoTherapy of Cancer2051-14262020-10-018210.1136/jitc-2019-000334Prognostic value of immune score in nasopharyngeal carcinoma using digital pathologyNa Liu0Lei Chen1Wei Jiang2Yu Zhang3Yu-Pei Chen4Ya-Qin Wang5Yan-Ping Mao6Ying-Qing Li7Shuo-Yu Xu8Xiao-Min Li9Qing-Mei He10Shi-Wei He11Xiao-Jing Yang12Yuan Lei13Yin Zhao14Jing-Ping Yun15Yingqin Li16The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China1 Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Brain Health and Brain Technology Center at Global Institute of Future Technology, Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, ChinaShanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China1WuXi AppTec, Nantong, Jiangsu, Chinaassociate professor1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, Chinaprofessor1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, China1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis andTherapy, Sun Yat-sen University Cancer Center, GuangZhou, ChinaBackground Tumor-infiltrating lymphocytes have been reported as prognostic markers in tumors. We aimed to assess the prognostic value of total T cell (CD3+) density, cytotoxic T cell (CD8+) density and memory T cell (CD45RO+) density in patients with nasopharyngeal carcinoma (NPC).Methods The expression of CD3, CD8 and CD45RO was detected by immunohistochemistry in the training (n=221) and validation cohorts (n=115). The densities of these three markers were quantified by digital pathology both in the tumor and stroma. Then, we developed the immune score based on the density of these three markers and further analyzed its prognostic value.Results The high density of CD3+, CD8+ and CD45RO+ T cells both in the tumor and/or stroma were significantly associated with the decrease in mortality in the training cohort, respectively. High immune score predicted a prolonged overall survival (OS) (HR 0.34, 95% CI 0.18 to 0.64, p=0.001, disease-free survival (DFS) (HR 0.44, 95% CI 0.25 to 0.78, p=0.005) and distant metastasis-free survival (DMFS) (HR 0.43, 95% CI 0.21 to 0.87, p=0.018) in NPC patients. The findings were confirmed in the validation cohort. Multivariate analysis revealed that immune score remained an independent prognostic indicator for OS, DFS and DMFS. In addition, we established a nomogram with the integration of all independent variables to predict individual risk of death.Conclusions We established an immune score model, which provides a reliable estimate of the risk of death, disease progress and distant metastasis in NPC patients.https://jitc.bmj.com/content/8/2/e000334.full
spellingShingle Na Liu
Lei Chen
Wei Jiang
Yu Zhang
Yu-Pei Chen
Ya-Qin Wang
Yan-Ping Mao
Ying-Qing Li
Shuo-Yu Xu
Xiao-Min Li
Qing-Mei He
Shi-Wei He
Xiao-Jing Yang
Yuan Lei
Yin Zhao
Jing-Ping Yun
Yingqin Li
Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
Journal for ImmunoTherapy of Cancer
title Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
title_full Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
title_fullStr Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
title_full_unstemmed Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
title_short Prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
title_sort prognostic value of immune score in nasopharyngeal carcinoma using digital pathology
url https://jitc.bmj.com/content/8/2/e000334.full
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