Morphological lymphocytic reaction, patient prognosis and PD-1 expression after surgical resection for oesophageal cancer.

Abstract

BACKGROUND:

Immune checkpoint inhibitors, such as antibody against programmed cell death protein (PD-1), have demonstrated antitumour effects in patients with malignancies, including oesophageal cancer. A lymphocytic reaction observed by pathological examination is a manifestation of the host immune response to tumour cells. It was hypothesized that a stronger lymphocytic reaction to tumours might be associated with favourable prognosis in oesophageal cancer.

METHODS:

Using a database of resected oesophageal cancers, four morphological components of lymphocytic reactions (peritumoral, intranest, lymphoid and stromal) to tumours were evaluated in relation to clinical outcome, PD-1 expression by immunohistochemistry and total lymphocyte count in blood.

RESULTS:

Resected oesophageal cancer specimens from 436 patients were included in the study. Among the four morphological components, only peritumoral reaction was associated with patient prognosis (multivariable P for trend <0·001); patients with a higher peritumoral reaction had significantly longer overall survival than those with a lower reaction (multivariable hazard ratio 0·48, 95 per cent c.i. 0·34 to 0·67). The prognostic effect of peritumoral reaction was not significantly modified by other clinical variables (all P for interaction >0·050). Peritumoral reaction was associated with total lymphocyte count in the blood (P < 0·001), supporting the relationship between local immune response and systemic immune competence. In addition, higher morphological peritumoral reaction was associated with high PD-1 expression on lymphocytes in tumours (P = 0·034).

CONCLUSION:

These findings should help to improve risk-adapted therapeutic strategies and help stratify patients in the future clinical setting of immunotherapy for oesophageal cancer.

• Authors: Y Baba, T Yagi, K Kosumi, K Okadome, D Nomoto, K Eto, Y Hiyoshi, Y Nagai, T Ishimoto, M Iwatsuki, S Iwagami, Y Miyamoto, N Yoshida, Y Komohara, M Watanabe, H Baba
• Journal: The British journal of surgery (Br J Surg) Vol. 106 Issue 10 Pg. 1352-1361 (09 2019) ISSN: 1365-2168 [Electronic] England
• PMID: 31414718 (Publication Type: Journal Article)
• Copyright: © 2019 BJS Society Ltd Published by John Wiley & Sons Ltd.

Chemical References

• PDCD1 protein, human
• Programmed Cell Death 1 Receptor

Topics

• Aged
• Esophageal Neoplasms (immunology, mortality, surgery)
• Female
• Humans
• Lymphocyte Count
• Lymphocytes (immunology, metabolism)
• Male
• Prognosis
• Programmed Cell Death 1 Receptor (metabolism)
• Retrospective Studies
• Survival Analysis