Clinical Research Papers:
Prediction of radio-responsiveness with immune-profiling in patients with rectal cancer
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In Ja Park1, Soyeon An5, Sang-Yeob Kim3,4, Hye Min Lim4, Seung-Mo Hong2, Mi-Ju Kim4, Yun Jae Kim4 and Chang Sik Yu1
1Department of Colon and Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
2Department of Pathology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
3Department of Convergence Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea
4Asan Institute for life sciences, Asan Medical Center, Seoul, Korea
5Department of Pathology, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
Chang Sik Yu, email: [email protected]
Sang-Yeob Kim, email: [email protected]
Keywords: rectal cancer, preoperative chemoradiotherapy, responsiveness, immune infiltrates
Received: April 04, 2017 Accepted: July 14, 2017 Published: July 25, 2017
We evaluate whether the tumor immune infiltrate (TIL) could be used for prediction of responsiveness to preoperative chemoradiotherapy (PCRT) in rectal cancers. Using formalin-fixed paraffin-embedded slides of pretreatment biopsies, co-stain for CD4, CD8, CD274 (PD-L1), FOXP3, cytokeratin, and DAPI was performed with Opal multi staining kit (Perkin-Elmer, Waltham, MA). Multispectral imaging and digital analysis to visualize and quantify specific immune infiltrates were performed using the Vectra imaging system (Perkin-Elmer). The density (number of cells per mm2) and proportion of total TILs and specific cell types in the stroma were calculated by inForm™ 2.2.1 software (Perkin-Elmer). The density and proportion of total TILs and specific cell types in the stroma were calculated by inForm™ 2.2.1 software (Perkin-Elmer, Waltham, MA). Patients were classified as group with total regression (TR, n = 25) and group with residual disease (near total, moderate, and minimal regression, RD, n = 50). The mean density of T cell infiltration and CD274 (PD-L1)+ lymphocyte were significantly higher in TR (p = 0.005, p = 0.001). The proportion of CD4+ lymphocyte (p=0.042) and CD274 (PD-L1)+ lymphocyte (p = 0.002) were different between 2 groups. The TR group has lower CD4+ and higher CD274 (PD-L1)+ proportions than RD group. The ratio among CD4+, CD8+, CD274 (PD-L1)+, FOXP3+ T cell was different between groups. TR group showed lower CD4/ CD274 (PD-L1) (p = 0.007), CD8/ CD274 (PD-L1) (p = 0.02), and FOXP3/ CD274 (PD-L1) (p = 0.003) ratio than RD group. The determination of the immune infiltrate in biopsies before treatment could be a valuable information for the prediction of responsiveness to PCRT.
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