Zone Formation of Lymphocyte Infiltration at the Invasive Front Results in the Prolonged Survival of Individuals With Endometrial Serous Carcinoma and Endometrioid Carcinoma With Serous Component

Abstract

Background/Aim: This study aimed to evaluate the clinical significance of lymphocyte infiltration (LI) for patients with endometrial serous carcinoma and those with endometrioid carcinoma including serous component. Patients and Methods: Patients who underwent surgery at our hospital between 1990 and 2013 were identified. LI was classified into strong LI, defined as a continuous thick zone of LI, and weak LI, defined as the lack of zone or scattered small foci of LI at the invasive front. Results: Out of a total of 51 patients, 38 cases had weak LI and 13 had strong LI. The progression-free survival of patients with weak LI was worse (p=0.02). No significant difference of overall survival according to the status of LI was noted (p=0.054). Multivariate analysis revealed that LI was a prognostic factor of poorer progression-free survival (hazard ratio(HR)=5. 05, p<0.01) and overall survival (HR=6.93, p=0.01). Conclusion: LI might be a new biomarker of such conditions.

A New Model to Improve the Prediction of Prognosis of Endometrial Carcinoma by Combining Traditional Classification With the Presence of Tumor-infiltrating Lymphocytes

“…Several reports have revealed an important association between TILs and the prognosis of endometrioid carcinoma (8)(9)(10)(11)(12)(22)(23)(24). These studies demonstrated that cluster of differentiation (CD)3 + T-lymphocytes, CD8 + T-lymphocytes, CD45R0 + T-lymphocytes, and CD8 + /forkhead box protein (FOXP)3 + ratios were associated with prognosis.…”

“…Several previous studies evaluated TILs in the tumor stroma (8,9,(22)(23)(24). However, our earlier reports focused on TILs at the invasive front and indicated their importance in prognosis (10,11). Recently, Pagès et al suggested that the presence of CD3 + as well as cytotoxic CD8 + T-cells in the tumor and in the invasive margin constitute prognostic factors for patients with colon cancer (27).…”

“…Recently, tumor-infiltrating lymphocytes (TILs) have been found to be associated with clinical outcomes in several carcinoma types, as well as with tumor malignancy and prognosis (5)(6)(7). TILs present in the tumor stroma and at the invasive front are important factors in endometrial carcinoma, and have been associated with the International Federation of Gynecology and Obstetrics (FIGO) staging of endometrial carcinoma, along with histological subtype, lymphovascular invasion, and prognosis (8)(9)(10)(11). TILs are also associated with DNA polymerase epsilon (POLE) mutations and microsatellite instability (MSI) in tumor cells (12).…”