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Stulpinas R, Zilenaite-Petrulaitiene D, Rasmusson A, Gulla A, Grigonyte A, Strupas K, Laurinavicius A. Prognostic Value of CD8+ Lymphocytes in Hepatocellular Carcinoma and Perineoplastic Parenchyma Assessed by Interface Density Profiles in Liver Resection Samples. Cancers (Basel) 2023; 15:cancers15020366. [PMID: 36672317 PMCID: PMC9857181 DOI: 10.3390/cancers15020366] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 12/28/2022] [Accepted: 01/04/2023] [Indexed: 01/08/2023] Open
Abstract
Hepatocellular carcinoma (HCC) often emerges in the setting of long-standing inflammatory liver disease. CD8 lymphocytes are involved in both the antitumoral response and hepatocyte damage in the remaining parenchyma. We investigated the dual role of CD8 lymphocytes by assessing density profiles at the interfaces of both HCC and perineoplastic liver parenchyma with surrounding stroma in whole-slide immunohistochemistry images of surgical resection samples. We applied a hexagonal grid-based digital image analysis method to sample the interface zones and compute the CD8 density profiles within them. The prognostic value of the indicators was explored in the context of clinicopathological, peripheral blood testing, and surgery data. Independent predictors of worse OS were a low standard deviation of CD8+ density along the tumor edge, high mean CD8+ density within the epithelial aspect of the perineoplastic liver-stroma interface, longer duration of surgery, a higher level of aspartate transaminase (AST), and a higher basophil count in the peripheral blood. A combined score, derived from these five independent predictors, enabled risk stratification of the patients into three prognostic categories with a 5-year OS probability of 76%, 40%, and 8%. Independent predictors of longer RFS were stage pT1, shorter duration of surgery, larger tumor size, wider tumor-free margin, and higher mean CD8+ density in the epithelial aspect of the tumor-stroma interface. We conclude that (1) our computational models reveal independent and opposite prognostic impacts of CD8+ cell densities at the interfaces of the malignant and non-malignant epithelium interfaces with the surrounding stroma; and (2) together with pathology, surgery, and laboratory data, comprehensive prognostic models can be constructed to predict patient outcomes after liver resection due to HCC.
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Affiliation(s)
- Rokas Stulpinas
- Faculty of Medicine, Institute of Biomedical Sciences, Department of Pathology, Forensic Medicine and Pharmacology, Vilnius University, 03101 Vilnius, Lithuania
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Clinics, 08406 Vilnius, Lithuania
- Correspondence:
| | - Dovile Zilenaite-Petrulaitiene
- Faculty of Medicine, Institute of Biomedical Sciences, Department of Pathology, Forensic Medicine and Pharmacology, Vilnius University, 03101 Vilnius, Lithuania
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Clinics, 08406 Vilnius, Lithuania
| | - Allan Rasmusson
- Faculty of Medicine, Institute of Biomedical Sciences, Department of Pathology, Forensic Medicine and Pharmacology, Vilnius University, 03101 Vilnius, Lithuania
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Clinics, 08406 Vilnius, Lithuania
| | - Aiste Gulla
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, 03101 Vilnius, Lithuania
- Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Agne Grigonyte
- Faculty of Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Kestutis Strupas
- Faculty of Medicine, Institute of Clinical Medicine, Vilnius University, 03101 Vilnius, Lithuania
| | - Arvydas Laurinavicius
- Faculty of Medicine, Institute of Biomedical Sciences, Department of Pathology, Forensic Medicine and Pharmacology, Vilnius University, 03101 Vilnius, Lithuania
- National Center of Pathology, Affiliate of Vilnius University Hospital Santaros Clinics, 08406 Vilnius, Lithuania
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Ramzan M, Sturm N, Decaens T, Bioulac-Sage P, Bancel B, Merle P, Tran Van Nhieu J, Slama R, Letoublon C, Zarski JP, Jouvin-Marche E, Marche PN, Leroy V. Liver-infiltrating CD8(+) lymphocytes as prognostic factor for tumour recurrence in hepatitis C virus-related hepatocellular carcinoma. Liver Int 2016. [PMID: 26215124 DOI: 10.1111/liv.12927] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND Chronic liver inflammation and immune/inflammatory response promote hepatocellular carcinoma. The aim of this study was to characterize the immune status of HCV-related cirrhosis in patients with hepatocellular carcinoma (HCV-HCC) as compared to HCV patients without hepatocellular carcinoma. METHOD Immune markers (CD3, CD4, CD8, CD20, CD56, TCRγδ, FoxP3) and gene expression profiles (CD8α, CD8β, FoxP3, IL-6, IFN-γ, perforin, RANTES) were analysed in a test cohort by immunohistochemistry and quantitative RT-PCR analysis on serial non-tumorous and tumorous tissues. RESULTS Immune micro-environment was more inflammatory in HCV-HCC than HCV cirrhotic livers. The number of CD3(+) , CD4(+) , CD8(+) and CD20(+) liver-infiltrating lymphocytes was significantly higher, whereas the number of CD56(+) cells was significantly lower in HCV-HCC compared to HCV cirrhotic parenchyma. These differences were restricted to fibrous septa for CD4(+) and CD20(+) cells and to nodular parenchyma for CD8(+) cells. Gene expressions of CD8α, FoxP3 and RANTES were also significantly higher in HCV-HCC than in HCV cirrhosis. Interestingly, in a large cohort of 63 HCV-HCC patients. The number of CD8(+) cells ≥100/field was associated with significant higher tumour recurrence (P = 0.003) and lower overall survival (P = 0.05) at 5 years. CONCLUSION High densities of liver-infiltrating lymphocytes in HCV-HCC cirrhotic parenchyma prevail inflammatory conditions and could contribute to tumorigenesis and tumour recurrence. These results could contribute towards better clinical evaluation of patients susceptible for HCC recurrence after curative surgery.
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Affiliation(s)
- Muhammad Ramzan
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France
| | - Nathalie Sturm
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Département d'Anatomie et de Cytologie Pathologiques, CHU de Grenoble, Grenoble, France
| | - Thomas Decaens
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Clinique d' Hépatogastroentérologie, pôle DigiDune, CHU de Grenoble, Grenoble, France
| | - Paulette Bioulac-Sage
- Service d'Anatomie et de Cytologie Pathologiques, Hôpital Pellegrin, Bordeaux, France
| | - Brigitte Bancel
- Service de Pathologie, Hôpital de la Croix Rousse, Lyon, France.,Université Claude Bernard Lyon 1, INSERM UMR-S1052, Centre de Recherche en Cancérologie de Lyon, Lyon, France.,Hospices Civils de Lyon, Lyon, France
| | - Philippe Merle
- Université Claude Bernard Lyon 1, INSERM UMR-S1052, Centre de Recherche en Cancérologie de Lyon, Lyon, France.,Hospices Civils de Lyon, Lyon, France.,Service d'Hépatologie, Hôpital de la Croix-Rousse, Lyon, France
| | - Jeanne Tran Van Nhieu
- Département de Pathologie, APHP, Groupe Hospitalier Henri Mondor, Val de Marne, Université Paris Est-Créteil, Créteil, France
| | - Rémy Slama
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France
| | - Christian Letoublon
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Clinique de Chirurgie Digestive, pôle DIGIDUNE, CHU de Grenoble, Grenoble, France
| | - Jean-Pierre Zarski
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Clinique d' Hépatogastroentérologie, pôle DigiDune, CHU de Grenoble, Grenoble, France
| | - Evelyne Jouvin-Marche
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France
| | - Patrice N Marche
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Clinique d' Hépatogastroentérologie, pôle DigiDune, CHU de Grenoble, Grenoble, France
| | - Vincent Leroy
- INSERM, Unité 823, Grenoble, France.,Université Grenoble-Alpes, Faculté de Médecine, UMR-S823, Grenoble, France.,Clinique d' Hépatogastroentérologie, pôle DigiDune, CHU de Grenoble, Grenoble, France
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