Expressions of CD8+TILs, PD-L1 and Foxp3+TILs in stage I NSCLC guiding adjuvant chemotherapy decisions
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Feifei Teng1, Xiangjiao Meng1, Xin Wang1, Jupeng Yuan3, Sujing Liu1, Dianbin Mu2, Hui Zhu1, Li Kong1, Jinming Yu1
1Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
2Department of Pathology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
3Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
Jinming Yu, email: [email protected]
Li Kong, email: [email protected]
Keywords: non-small cell lung cancer, TILs, PD-L1, Foxp3, adjuvant chemotherapy
Received: May 20, 2016 Accepted: August 13, 2016 Published: September 01, 2016
Purpose: Currently, adjuvant chemotherapy is recommended for patients with high risk stage I non-small cell lung cancer (NSCLC). However, identifying high risk patients remains a challenge. This study aims to identify the patient cohorts more likely to benefit from adjuvant chemotherapy based on the tumor micro-immune environment.
Results: CD8+TILs significantly associated with disease-free survival (DFS) and overall survial (OS) (p=0.002; 0.040). Patients with high risk factors may also predict shorter DFS (P=0.056). When compared together, patients with high-CD8+TILs showed better DFS than patients with low-CD8+TILs, no matter their risk factors status. There’s no correlation between PD-L1 expressions and survival. PD-L1 was highly expressed in men, squamous and well differentiated carcinoma. In addition, Foxp3+TILs alone didn’t show any prognostic effects, but low-Foxp3/high-CD8+TILs were associated with prolonged DFS (p=0.031).
Methods: A total of 126 patients with surgically resected stage I NSCLC were included to perform immunohistochemistry of CD8+ tumor infiltrating lymphocytes (TILs), programmed death ligand-1(PD-L1) and forkhead box P3 (Foxp3)+TILs.
Conclusion: CD8+TILs are effective prognostic predictors. Patients with surgically resected stage I NSCLC showing low CD8+TILs could be considered for adjuvant chemotherapy, even if they have no high risk features.
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