PMID- 35127901
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220208
IS  - 2307-8960 (Print)
IS  - 2307-8960 (Electronic)
IS  - 2307-8960 (Linking)
VI  - 10
IP  - 3
DP  - 2022 Jan 21
TI  - Evaluating tumor-infiltrating lymphocytes in hepatocellular carcinoma using 
      hematoxylin and eosin-stained tumor sections.
PG  - 856-869
LID - 10.12998/wjcc.v10.i3.856 [doi]
AB  - BACKGROUND: Tumor-infiltrating lymphocytes (TILs) constitute a prognostic factor 
      in hepatocellular carcinoma (HCC). However, different methods of assessing TILs 
      have various pre-analytical, analytical, and post-analytical challenges. The 
      evaluation of TILs in hematoxylin and eosin (H&E)-stained tumor sections proposed 
      by the International Immuno-Oncology Biomarker Working Group was demonstrated to 
      be a reproducible, affordable and easily applied method in many tumors. AIM: To 
      evaluate the prognostic significance of TILs in H&E-stained slides of HCCs. 
      METHODS: This was a retrospective study performed in the hospital. HCC patients 
      who underwent liver resection between 2015 and 2017 in Zhongshan Hospital were 
      enrolled in this study. Patients who experienced recurrence or received therapy 
      in addition to antiviral therapy before surgery at this time were excluded. A 
      total of 204 patients were enrolled in the study. The ILs were counted manually 
      in tumor sections stained with H&E under an optical microscope at 400 x. The ILs 
      were assessed separately in the center of the tumor (TILs(CT)), the invasive 
      front (TILs(IF)), and peritumor (PILs) areas. Univariate and multivariate 
      survival analyses were performed using a Cox regression model. P < 0.05 was 
      considered statistically significant and all P-values were two-sided. RESULTS: 
      Among the 204 patients, univariate analysis indicated that macrovascular invasion 
      (MaVI) (P = 0.001), microvascular invasion (MVI) (P = 0.012), multiple tumors (P 
      = 0.008), large tumors (> 10 cm) (P = 0.001), absence of a tumor capsule (P = 
      0.026), macrotrabecular histological subtype (P = 0.001), low density of TILs(CT) 
      (P = 0.039), TILs(IF) (P = 0.014), and PILs (P = 0.010) were predictors of 
      progression-free survival (PFS). Cox multivariate analysis indicated that MaVI (P 
      = 0.009), absence of a tumor capsule (P = 0.031), low-density of TILs(IF) (P = 
      0.047) and PILs (P = 0.0495) were independent predictors of PFS. A three-category 
      analysis was carried out by combining TILs(CT), TILs(IF), and PILs, after which 
      HCCs were classified into immune(high) [(TILs(CT))(high), (TILs(IF))(high), and 
      PILs(high), 83 cases], immune(mod) (tumors other than immune(high) and 
      immune(low) subtypes, 94 cases), and immune(low) [(TILs(CT))(low), 
      (TILs(IF))(low), and PILs(low), 27 cases)] subtypes. The immune(high) subtype had 
      a lower rate of MVI (40.96%) than the immune(mod) (61.70%, P = 0.017) and 
      immune(low) (66.67%, P = 0.020) subtypes. The recurrence rates of the 
      immune(high), immune(mod) and immune(low) subtypes were 10.8%, 25.5% and 33.3%, 
      respectively. CONCLUSION: HCC patients with high infiltrating lymphocytes tend to 
      have a lower recurrence rate and less MVI. The evaluation of TILs in H&E-stained 
      specimens could be a prognostic parameter for HCC.
CI  - (c)The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights 
      reserved.
FAU - Du, Min
AU  - Du M
AD  - Department of Pathology, Huadong Hospital, Fudan University, Shanghai 200040, 
      Shanghai Province, China.
FAU - Cai, Yu-Meng
AU  - Cai YM
AD  - Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, 
      Shanghai Province, China.
FAU - Yin, Yu-Lei
AU  - Yin YL
AD  - Department of Pathology, Huadong Hospital, Fudan University, Shanghai 200040, 
      Shanghai Province, China.
FAU - Xiao, Li
AU  - Xiao L
AD  - Department of Pathology, Huadong Hospital, Fudan University, Shanghai 200040, 
      Shanghai Province, China.
FAU - Ji, Yuan
AU  - Ji Y
AD  - Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, 
      Shanghai Province, China. ji.yuan@zs-hospital.sh.cn.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - World J Clin Cases
JT  - World journal of clinical cases
JID - 101618806
PMC - PMC8790462
OTO - NOTNLM
OT  - Hematoxylin and eosin-stained
OT  - Hepatocellular carcinoma
OT  - Lymphocytes
OT  - Pathology
OT  - Tumor infiltration
COIS- Conflict-of-interest statement: We have no financial relationships to disclose.
EDAT- 2022/02/08 06:00
MHDA- 2022/02/08 06:01
PMCR- 2022/01/21
CRDT- 2022/02/07 05:35
PHST- 2021/08/18 00:00 [received]
PHST- 2021/10/13 00:00 [revised]
PHST- 2021/12/23 00:00 [accepted]
PHST- 2022/02/07 05:35 [entrez]
PHST- 2022/02/08 06:00 [pubmed]
PHST- 2022/02/08 06:01 [medline]
PHST- 2022/01/21 00:00 [pmc-release]
AID - 10.12998/wjcc.v10.i3.856 [doi]
PST - ppublish
SO  - World J Clin Cases. 2022 Jan 21;10(3):856-869. doi: 10.12998/wjcc.v10.i3.856.