Prognostic Significance of Tumor-Infiltrating Lymphocytes in Patients With Pancreatic Ductal Adenocarcinoma Treated With Neoadjuvant Chemotherapy.

Abstract

OBJECTIVES:

The aim of this study was to examine tumor-infiltrating lymphocytes (TILs) and their prognostic value in patients with pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy.

METHODS:

Intratumoral CD4, CD8, and FOXP3 lymphocytes were examined by immunohistochemistry using a computer-assisted quantitative analysis in 136 PDAC patients who received neoadjuvant therapy and pancreaticoduodenectomy. The results were correlated with clinicopathological parameters and survival.

RESULTS:

High CD4 TILs in treated PDAC were associated with high CD8 TILs (P = 0.003), differentiation (P = 0.04), and a lower frequency of recurrence (P = 0.02). Patients with high CD4 TILs had longer disease-free survival and overall survival (OS) than did patients with low CD4 TILs (P < 0.01). The median OS of patients with a high CD8/FOXP3 lymphocyte ratio (39.5 [standard deviation, 6.1] months) was longer than that of patients with a low CD8/FOXP3 lymphocyte ratio (28.3 [standard deviation, 2.3] months; P = 0.01). In multivariate analysis, high CD4 TILs were an independent prognostic factor for disease-free survival (hazard ratio, 0.49; 95% confidence interval, 0.30-0.81; P = 0.005) and OS (hazard ratio, 0.54; 95% confidence interval, 0.33-0.89; P = 0.02).

CONCLUSIONS:

High level of CD4 lymphocytes is associated with tumor differentiation and lower recurrence and is an independent prognostic factor for survival in PDAC patients treated with neoadjuvant therapy.

• Authors: Reza Nejati, Jennifer B Goldstein, Daniel M Halperin, Hua Wang, Nazila Hejazi, Asif Rashid, Matthew H Katz, Jeffrey E Lee, Jason B Fleming, Jaime Rodriguez-Canales, Jorge Blando, Ignacio I Wistuba, Anirban Maitra, Robert A Wolff, Gauri R Varadhachary, Huamin Wang
• Journal: Pancreas (Pancreas) Vol. 46 Issue 9 Pg. 1180-1187 (10 2017) ISSN: 1536-4828 [Electronic] United States
• PMID: 28902789 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Pancreatic Ductal (drug therapy, pathology, surgery)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Disease-Free Survival
• Female
• Humans
• Lymphocytes, Tumor-Infiltrating (pathology)
• Male
• Middle Aged
• Neoadjuvant Therapy
• Pancreatic Neoplasms (drug therapy, pathology, surgery)
• Pancreaticoduodenectomy
• Prognosis