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BIBTEX RIS

CD 8+ tumour‐infiltrating lymphocytes and COX2 expression may predict relapse in differentiated thyroid cancer

2014; Wiley; Volume: 83; Issue: 2 Linguagem: Inglês

10.1111/cen.12586

1365-2265

Lucas Leite Cunha, Marjory Alana Marcello, Suely Nonogaki, Elaine Cristina Morari, Fernando Augusto Soares, José Vassallo, Laura Sterian Ward,

Vitamin D Research Studies

Summary Background/objective There is an increasing rate of papillary thyroid carcinomas that may never progress to cause symptoms or death. Predicting outcome and determining tumour aggressiveness could help diminish the number of patients submitted to aggressive treatments. We aimed to evaluate whether markers of the immune system response and of tumour‐associated inflammation could predict outcome of differentiated thyroid cancer ( DTC ) patients. Design Retrospective cohort study. Patients We studied 399 consecutive patients, including 325 papillary and 74 follicular thyroid carcinomas. Measurements Immune cell markers were evaluated using immunohistochemistry, including tumour‐associated macrophages ( CD 68) and subsets of tumour‐infiltrating lymphocytes ( TIL ), such as CD 3, CD 4, CD 8, CD 16, CD 20, CD 45 RO , GRANZYME B, CD 69 and CD 25. We also investigated the expression of cyclooxygenase 2 ( COX 2) in tumour cells and the presence of concurrent lymphocytic infiltration characterizing chronic thyroiditis. Results Concurrent lymphocytic infiltration characterizing chronic thyroiditis was observed in 29% of the cases. Among all the immunological parameters evaluated, only the enrichment of CD 8+ lymphocytes ( P = 0·001) and expression of COX 2 ( P =0·01) were associated with recurrence. A multivariate model analysis identified CD 8+ TIL / COX 2 as independent risk factor for recurrence. A multivariate analysis using Cox's proportional‐hazards model adjusted for the presence of concurrent chronic thyroiditis demonstrated that the presence of concurrent chronic thyroiditis had no effect on prognostic prediction mediated by CD 8+ TIL and COX 2. Conclusion In conclusion, we suggest the use of a relatively simple pathology tool to help select cases that may benefit of a more aggressive approach sparing the majority of patients from unnecessary procedures.