Abstract
Objectives: To determine the prognostic significance of spatial proximity of lung cancer cells and specific immune cells in the tumor microenvironment. Materials and methods: We probed formalin-fixed, paraffin-embedded (FFPE) tissue microarrays using a novel tyramide signal amplification multiplexing technique labelling CD8, CD4, Foxp3, and CD68+ cells. Each multiplex stained immunohistochemistry slide was digitally processed by Vectra INFORMS software, and an X- and Y-coordinate assigned to each labeled cell type. The abundance and spatial location of each cell type and their proximity to one another was analyzed using a novel application of the G-cross spatial distance distribution method which computes the probability of finding at least one immune cell of any given type within a rμm radius of a tumor cell. Cox proportional hazards multiple regression was used for multivariate analysis of the influence of proximity of lymphocyte types. Results: Pathologic tumor specimens from 120 NSCLC patients with pathologic tumor stage I–III disease were analyzed. On univariate analysis, age (P =.0007) and number of positive nodes (P =.0014) were associated with overall survival. Greater area under the curve (AUC) of the G-cross function for tumor cell-Treg interactions was significantly associated with worse survival adjusting for age and number of positive nodes (HR 1.52 (1.11–2.07), P =.009). Greater G-cross AUC for T-reg-CD8 was significantly associated with better survival adjusting for age and number of positive lymph nodes (HR 0.96 (0.92–0.99), P =.042). Conclusion: Increased infiltration of regulatory T cells into core tumor regions is an independent predictor of worse overall survival in NSCLC. However, increased infiltration of CD8+ cytotoxic T cells among regulatory T cells seems to mitigate this effect and was significantly associated with better survival. Validation of the G-cross method of measuring spatial proximity between tumor and immune cell types and exploration of its use as a prognostic factor in lung cancer treatment is warranted.
Original language | English (US) |
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Pages (from-to) | 73-79 |
Number of pages | 7 |
Journal | Lung Cancer |
Volume | 117 |
DOIs | |
State | Published - Mar 2018 |
Keywords
- Immune cells
- Intratumoral T cells
- Non-small cell lung cancer
- Spatial computation
- Spatial distances
- T regulatory cells
ASJC Scopus subject areas
- Oncology
- Pulmonary and Respiratory Medicine
- Cancer Research