ABSTRACT
AIM: To study the prognostic value of the density of tumor-infiltrating lymphocytes (TILs) and its association with other clinical-morphological parameters in colon adenocarcinomas (CAC). MATERIALS AND METHODS: 236 CAC samples were examined. TILs density was estimated as the percentage of tumor stromal area occupied by TILs. By the index of TILs density, the patients were divided into 3 groups: TILs 0-9% (n = 88); TILs 10-39% (n = 106); TILs > 40% (n = 42). Dependent on this index, their overall survival (OS) was analyzed. RESULTS: Kaplan - Meier curves revealed a significant (p < 0.001) difference in the OS for patients with different TILs infiltration intensities. Multivariate Cox's proportional hazard regression model analysis has confirmed that patients with moderate TILs density (HR 0.57, 95% CI 0.34-0.96, p = 0.035) had better OS rates compared to low TILs density. TILs were associated with the stage (p < 0.001), lymph node metastasis pN (p < 0.001), distant metastasis M (p < 0.001), and the patient's outcome (p < 0.001). CONCLUSION: TILs can be considered an additional prognostic tool during regular histological examination and are strongly associated with the most significant clinical-morphological features of CAC.
Subject(s)
Adenocarcinoma , Colonic Neoplasms , Lymphocytes, Tumor-Infiltrating , Humans , Lymphocytes, Tumor-Infiltrating/pathology , Lymphocytes, Tumor-Infiltrating/immunology , Colonic Neoplasms/pathology , Colonic Neoplasms/mortality , Colonic Neoplasms/immunology , Prognosis , Adenocarcinoma/pathology , Adenocarcinoma/mortality , Adenocarcinoma/immunology , Male , Female , Middle Aged , Aged , Adult , Neoplasm Staging , Aged, 80 and over , Kaplan-Meier Estimate , Proportional Hazards Models , Lymphatic Metastasis/pathologyABSTRACT
AIM: To determine the prognostic value of tumor-infiltrating lymphocytes (TILs) in colon adenocarcinomas. MATERIALS AND METHODS: The study was performed on 180 paraffin blocks of operation material from patients diagnosed with adenocarcinoma of the colon, treated at the Kyiv City Oncology Center in 2013-2018. TILs were counted on histological slides stained with hematoxylin-eosin. By TILs count percentage in tumor slides, the samples were divided into three groups: 0-9% TILs (n = 65); 10-39% TILs (n = 79); and > 40% TILs (n = 36). RESULTS: Kaplan - Meyer estimate showed that the difference in overall survival between groups was significant (p = 0.001). Multivariate Cox's proportional hazard regression model analysis evidenced on significantly better overall survival rates in groups with moderate TILs percentage (hazard ratio 0.54, 95% CI 0.30-0.97, p = 0.042) and high TILs percentage (hazard ratio 0.36, 95% CI 0.13-0.99, p = 0.049), respectively, as compared with low TILs percentage group. CONCLUSION: TILs content can be considered as an independent prognostic factor for colon adenocarcinoma and used as an additional tool in routine practice of pathologists.
