Pathological features related to onco-immunity and their clinical significance of pancreatic ductal adenocarcinoma.
10.3760/cma.j.cn112151-20210902-00641
- Author:
Can Ming WANG
1
;
Chen Yang XU
2
;
Shan JIANG
3
;
Qiang ZHOU
4
;
Zhi Jun JIANG
5
;
Guo Ping CHENG
1
;
Mei Juan WU
1
;
Ting Ting FENG
6
;
Wen Juan YIN
1
Author Information
1. Department of Pathology, the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou 310022, China.
2. Department of Oncology, the First Clinical School of Wenzhou Medical University, Wenzhou 325035, China.
3. Department of Pathology, Chinese Medical Hospital of Haining, Haining 314400, China.
4. Department of Pathology, the First Hospital of Xiaoshan District, Hangzhou 311201, China.
5. Department of Pathology, the First Hospital of Fuyang District, Hangzhou 311499, China.
6. Department of Abdominal Medical Oncology, the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital), Hangzhou 310022, China.
- Publication Type:Journal Article
- MeSH:
Adenocarcinoma/pathology*;
B7-H1 Antigen/metabolism*;
Biomarkers, Tumor/metabolism*;
Carcinoma, Pancreatic Ductal/pathology*;
Humans;
Inflammation/pathology*;
Lymphocytes, Tumor-Infiltrating/metabolism*;
Pancreatic Neoplasms/pathology*;
Prognosis;
Tumor Microenvironment
- From:
Chinese Journal of Pathology
2022;51(5):419-424
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To investigate the tumor immunity-related pathologic features and clinical significance in pancreatic ductal adenocarcinoma (PDAC). Methods: All pathologic materials and clinical information of 192 PDAC patients from the Cancer Hospital of the University of Chinese Academy of Sciences from January 2010 to December 2020 were collected. The onco-immune microenvironment associated morphologic features were evaluated, and MHC-Ⅰ, PD-L1, CD3, and CD8 expression were detected by immunohistochemistry (IHC). Then the correlation between the factors and their influence on prognosis was analyzed. Results: There were 163 cases of non-specific adenocarcinoma (163/192, 84.90%), 18 cases of adeno-squamous carcinoma (18/192, 9.37%), and 11 cases of other rare subtypes (11/192, 5.73%). Perineural invasion was observed in 110 cases (110/192, 57.29%) and vascular invasion in 86 cases (86/192, 44.79%). There were 84 cases (84/182, 46.15%) with severe chronic inflammation. Tumor infiltrating immune cell numbers (TII-N) were increased in 52 cases (52/192, 27.08%). Lymphocytes and plasma cells were the main infiltrating immune cells in 60 cases (60/192, 31.25%), whereas in 34 cases (34/192, 17.71%) the tumors were mainly infiltrated by granulocytes, and 98 cases (98/192, 51.04%) showed mixed infiltration. CD3+T cells were deficient in 124 cases (124/192, 66.31%). CD8+T cells were deficient in 152 cases (152/192, 79.58%). MHC-Ⅰ expression was down-regulated in 156 cases (156/192, 81.25%), and PD-L1 was positive (CPS≥1) in 46 cases (46/192, 23.96%). Statistical analysis showed that TII-N was negatively correlated with vascular invasion (P=0.035), perineural invasion (P=0.002), stage (P=0.004) and long-term alcohol consumption (P=0.039). The type of immune cells correlated positively with chronic pancreatic inflammation (P=0.002), and negatively with tumor differentiation (P=0.024). CD8+T cells were positively correlated with CD3+T cells (P=0.032), MHC-Ⅰ expression (P<0.001) and PD-L1 expression (P=0.001), and negatively correlated with long-term smoking (P=0.016). Univariate analysis showed that histological nonspecific type (P=0.013) and TII-N (P<0.001) were the factors for good prognosis. Vascular invasion (P=0.032), perineural invasion (P=0.001), high stage (P=0.003) and long-term alcohol consumption (P=0.004) were adverse prognostic factors. COX multivariate risk analysis found that TII-N was an independent favorable factor for PDAC, while perineural invasion was an independent adverse risk factor. Conclusions: TII-N is an independent superior prognostic factor for PDAC, and significantly correlated with many factors; chronic alcohol consumption and smoking may inhibit onco-immunity in PDAC patients.
