Tumour-associated CD66b+ neutrophil count is an independent prognostic
factor for recurrence in localised cervical cancer |
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Authors: | A Carus M Ladekarl H Hager B S Nedergaard F Donskov |
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Institution: | 1.Department of Experimental Clinical Oncology,
Aarhus University Hospital, Aarhus, Denmark;2.Department of Oncology, Aarhus University
Hospital, Aarhus, Denmark;3.Department of Pathology, Aarhus University
Hospital,, Aarhus, Denmark;4.Department of Pathology, Aalborg Hospital,
and Stereology and Electron Microscopy Research Laboratory, Aarhus University
Hospital, Aarhus, Denmark |
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Abstract: | Background: The prognostic impact of tumour-promoting immune cells in cervical cancer is
unclear.Methods: Federation of Gynaecology and Obstetrics (FIGO) stage IB and IIA cervical cancer
patients (N=101) were assessed for tumour-associated
CD66b+ neutrophils and CD163+ macrophages by
immunohistochemistry in whole tissue sections using stereology. Results were correlated
with previous results on tumour-infiltrating CD3+, CD4+,
and CD8+ lymphocytes in the same cohort with recurrence-free survival
(RFS) as end point.Results: The highest densities of CD66b+ neutrophils and CD163+
macrophages were observed in the peritumoural compartment (median
53.1 cells mm−2 and 1.3% area fraction,
respectively). Above median peritumoural and stromal CD66b+ neutrophils
and peritumoural CD163+ macrophages were significantly associated with
short RFS. Multivariate analysis identified high peritumoural neutrophils (HR 2.27;
95% CI 1.09–4.75; P=0.03), low peritumoural
CD8+ lymphocytes (HR 3.67; 95% CI 1.63–8.25;
P=0.002), and lymph node metastases (HR 2.70; 95% CI
1.26–5.76; P=0.01) as independent prognostic factors for short
RFS, whereas CD163+ macrophages were not significant. An index of
combined intratumoral and peritumoral CD66b+ neutrophils to
CD8+ lymphocytes had good discriminatory power for each quartile with
5-year RFS of 92%, 80%, 62%, and 44%
(P=0.001).Conclusion: Tumour-associated neutrophil count is an independent prognostic factor for short RFS in
localised cervical cancer. Combining CD66b and CD8 may further improve prognostic
stratification. These findings require prospective validation. |
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Keywords: | tumour-associated neutrophils tumour-associated macrophages stereology cancer inflammation cervix carcinoma |
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