01.12.2017 | Research article | Ausgabe 1/2017 Open Access

Prognostic significance of tumor infiltrating immune cells in oral squamous cell carcinoma
- Zeitschrift:
- BMC Cancer > Ausgabe 1/2017
Background
Methods
Study population
Immunohistochemistry
Microscopic evaluation of tumor sections
Follow up
Statistical analysis
Results
Patients outcome
Factors
|
Number (range)
|
Percentage (%)
|
|
---|---|---|---|
Age
|
Mean (range)
|
60 (24–82)
|
|
Gender
|
Male
|
57
|
73.08
|
Female
|
21
|
26.92
|
|
Smoking
|
Yes
|
47
|
60.26
|
No
|
31
|
39.74
|
|
Drinking
|
Yes
|
42
|
53.85
|
No
|
36
|
46.15
|
|
Differentiation
|
Well
|
57
|
73.08
|
Moderate or poor
|
21
|
26.92
|
|
T stage
|
T1 and T2
|
58
|
74.36
|
T3 and T4
|
20
|
25.64
|
|
N stage
|
N0
|
48
|
61.54
|
N1-N3
|
30
|
38.46
|
|
Clinical stage
|
I and II
|
36
|
46.15
|
III and IV
|
42
|
53.85
|
The distribution of CD8+, CD4+, T-bet+, CD68+ and CD57+ cells in OSCC tissues
CD8
|
CD4
|
T-bet
|
CD68
|
CD57
|
|
---|---|---|---|---|---|
Mean (SD) cells/hpf
|
28.99(12.67)
|
62.06(21.33)
|
8.97(3.99)
|
21.25(6.01)
|
15.75(9.41)
|
Range
|
8–65
|
9–104
|
0–18
|
7–32
|
3–62
|
Relationships between clinicopathological features and density of immune cells
Factors
|
CD8
|
CD4
|
T-bet
|
CD68
|
CD57
|
||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Low
|
High
|
P-Value
|
Low
|
High
|
P-Value
|
Low
|
High
|
P-Value
|
Low
|
High
|
P-Value
|
Low
|
High
|
P-Value
|
|
Age
|
|||||||||||||||
< 60
|
18
|
17
|
0.981
|
17
|
18
|
0.821
|
21
|
14
|
0.046*
|
21
|
14
|
0.238
|
23
|
12
|
0.137
|
≥ 60
|
22
|
21
|
22
|
21
|
16
|
27
|
20
|
23
|
21
|
22
|
|||||
Gender
|
|||||||||||||||
Male
|
31
|
27
|
0.517
|
29
|
29
|
1
|
28
|
30
|
0.802
|
30
|
28
|
0.802
|
32
|
26
|
0.709
|
Female
|
9
|
11
|
10
|
10
|
9
|
11
|
11
|
9
|
12
|
8
|
|||||
Smoking
|
|||||||||||||||
Yes
|
27
|
21
|
0.27
|
25
|
23
|
0.644
|
23
|
25
|
0.915
|
24
|
24
|
0.569
|
28
|
20
|
0.667
|
No
|
13
|
17
|
14
|
16
|
14
|
16
|
17
|
13
|
16
|
14
|
|||||
Drinking
|
|||||||||||||||
Yes
|
27
|
15
|
0.014*
|
23
|
19
|
0.367
|
21
|
21
|
0.626
|
24
|
18
|
0.385
|
26
|
16
|
0.294
|
No
|
13
|
23
|
16
|
20
|
16
|
20
|
17
|
19
|
18
|
18
|
|||||
Differentiation
|
|||||||||||||||
Well
|
26
|
31
|
0.101
|
31
|
26
|
0.205
|
27
|
30
|
0.984
|
28
|
29
|
0.319
|
32
|
25
|
0.937
|
Moderate or Poor
|
14
|
7
|
8
|
13
|
10
|
11
|
13
|
8
|
12
|
9
|
|||||
T stage
|
|||||||||||||||
T1 and T2
|
29
|
29
|
0.702
|
29
|
29
|
1
|
26
|
32
|
0.435
|
28
|
30
|
0.199
|
30
|
28
|
0.158
|
T3 and T4
|
11
|
9
|
10
|
10
|
11
|
9
|
13
|
7
|
14
|
6
|
|||||
N stage
|
|||||||||||||||
N0
|
20
|
28
|
0.033*
|
23
|
25
|
0.644
|
22
|
26
|
0.722
|
24
|
24
|
0.569
|
21
|
27
|
0.005*
|
N1-N3
|
20
|
10
|
16
|
14
|
15
|
15
|
17
|
13
|
23
|
7
|
|||||
Clinical stage
|
|||||||||||||||
I and II
|
16
|
20
|
0.266
|
18
|
18
|
1
|
15
|
21
|
0.348
|
16
|
20
|
0.186
|
15
|
21
|
0.016*
|
III and IV
|
24
|
18
|
21
|
21
|
22
|
20
|
25
|
17
|
29
|
13
|
Assessment of survival by COX regression analysis
Univariate COX regression analyses and Kaplan-Meier survival curves
Factors
|
SE
|
P
|
Exp (β)
|
95.0% CI
|
|
---|---|---|---|---|---|
Gender
|
0.328
|
0.677
|
1.147
|
0.603
|
2.181
|
Age
|
0.293
|
0.555
|
0.841
|
0.473
|
1.494
|
Smoking
|
0.297
|
0.451
|
0.799
|
0.446
|
1.431
|
Drinking
|
0.299
|
0.277
|
1.384
|
0.771
|
2.485
|
T stage
|
0.319
|
0.301
|
1.391
|
0.744
|
2.600
|
N stage
|
0.313
|
<0.001*
|
3.784
|
2.048
|
6.989
|
Differentiation
|
0.315
|
0.307
|
1.379
|
0.744
|
2.557
|
Clinical stage
|
0.304
|
0.007*
|
2.264
|
1.248
|
4.109
|
CD8
|
0.329
|
<0.001*
|
3.808
|
1.998
|
7.256
|
CD4
|
0.299
|
0.207
|
0.686
|
0.382
|
1.232
|
T-bet
|
0.294
|
0.639
|
0.871
|
0.489
|
1.551
|
CD68
|
0.296
|
0.293
|
0.733
|
0.411
|
1.308
|
CD57
|
0.383
|
<0.001*
|
7.718
|
3.646
|
16.338
|
Multivariate COX regression analysis.
Factors
|
SE
|
P
|
Exp (β)
|
95% CI
|
||
---|---|---|---|---|---|---|
T stage
|
T1/T2
|
Reference
|
||||
T3/T4
|
0.487
|
0.529
|
1.359
|
0.523
|
3.530
|
|
N stage
|
N0
|
Reference
|
||||
N1-N3
|
0.602
|
0.008*
|
4.969
|
1.527
|
16.168
|
|
Clinical stage
|
I and II
|
Reference
|
||||
III and IV
|
0.667
|
0.282
|
0.488
|
0.132
|
1.804
|
|
CD8
|
Low
|
0.358
|
0.030*
|
2.174
|
1.078
|
4.384
|
High
|
Reference
|
|||||
CD4
|
Low
|
0.328
|
0.909
|
1.038
|
0.545
|
1.977
|
High
|
Reference
|
|||||
T-bet
|
Low
|
0.310
|
0.836
|
1.066
|
0.580
|
1.959
|
High
|
Reference
|
|||||
CD68
|
Low
|
0.316
|
0.177
|
1.533
|
0.825
|
2.848
|
High
|
Reference
|
|||||
CD57
|
Low
|
0.441
|
<0.001*
|
6.576
|
2.768
|
15.623
|
High
|
Reference
|
Predictive accuracy for OS
Predictive factors
|
AUC
|
SE
|
P
|
95% CI
|
|
---|---|---|---|---|---|
TNM
|
0.599
|
0.066
|
0.141
|
0.469
|
0.728
|
CD8
|
0.784
|
0.053
|
0.000
|
0.680
|
0.889
|
CD4
|
0.581
|
0.067
|
0.226
|
0.450
|
0.713
|
T-bet
|
0.651
|
0.063
|
0.024
|
0.528
|
0.774
|
CD68
|
0.533
|
0.068
|
0.624
|
0.399
|
0.667
|
CD57
|
0.868
|
0.042
|
0.000
|
0.785
|
0.950
|