T-helper 1 immunoreaction influences survival in muscle-invasive bladder cancer: proof of concept

1 Dec 2014
Alexandre Ingels, Rafael E Sanchez Salas, Vincent Ravery, Gaëlle Fromont-Hankard, Pierre Validire, Jean-Jacques Patard, Géraldine Pignot, Dominique Prapotnich, Fabien Olivier, Marc Galiano, Eric Barret, Francois Rozet, Nina Weber, Xavier Cathelineau

Objective: To define immunoscore in bladder cancer studying T helper 1 (Th1) immunoreaction. To define a cancer-specific survival model based on Th1 cells infiltration.

Methods: A total of 252 patients underwent primary transurethral resection of bladder tumour at our Institution. A retrospective review of a selected cohort with pT1 and muscle-invasive bladder cancer (MIBC) lesions was performed. Pathology blocks were marked with CD3 and CD8 antibodies. Immune cells density in stromal reaction (SR) was measured on five distinct high-power field (HPF) by two dedicated uro-pathologist blinded for patients’ evolution.

Statistics: Student test or non-parametric Wilcoxon test as appropriate to compare means between two groups. Receiver operating characteristics (ROC) curve to define markers threshold. Cox model to assess survival’s predictors.

Results: Ten pT1 and 20 MIBC consecutive cases were analysed. Median follow-up was 33.4 months. Immunohistological analysis for pT1 lesions featured limited SR. For MIBC, the mean density of lymphocytes in the SR was of 105/HPF (CD3) and 86/HPF (CD8). Survivors harboured higher lymphocytes densities versus non survivors (CD3: p = 0.0319; CD8: p = 0.0279). CD3 (p = 0.034) and CD8 (p = 0.034) lymphocytes densities were independently associated with cancer-specific survival on Cox model analyses. The retrospective design and small size of cohorts are the study limitations.

Conclusions: High CD3 and CD8 lymphocytes SR densities are associated with better cancer-specific survival for MIBC. Th1 reaction against the tumour seems to be protective for bladder cancer. Further evaluation is warranted.

Article metrics: 882 views

Related Articles

Aline F Fares, Daniel V Araujo, Vinicius Calsavara, Augusto Obuti Saito, Maria Nirvana Formiga, Aldo A Dettino, Stenio Zequi, Walter H da Costa, Isabela W Cunha
Fausto Maffini, Daniele Lorenzini, Daniela Lepanto, Elvio De Fiori, Caterina Fumagalli, Alessandra Rappa, Marta Tagliabue, Massimo Barberis
Luiz Fernando Quintanilha, Laumar Neves Souza, Daniel Sanches, Kiyoshi Ferreira Fukutani
Eugenia Cordero-García, Andrés Baéz-Astúa, Yolanda Roa-Martínez, Vanessa Ramírez-Mayorga, Warner Alpízar-Alpízar