Prognostic value of the CD4+/CD8+ ratio of tumour infiltrating lymphocytes in colorectal cancer and HLA-DR expression on tumour cells
The purpose of this study was to clarify whether HLA-DR expression of colorectal tumour cells or the CD4+/CD8+ ratio of the tumour infiltrating lymphocytes is significantly associated with the prognosis of colorectal cancer. Using flow cytometry, we studied the tumour cell expression of the HLA class II in 70 enzymatically dissociated colorectal cancers and the phenotype of tumour infiltrating lymphocytes (TILs) in 41 cases. There was no trend in 5-year survival between three levels (low, medium, high) of HLA-DR expression on the tumour cells. Patients with low CD4+/CD8+ ratios had a better clinical course, with significantly higher 5-year survival, p=0.046, independent of the Dukes stage and age. Our results have implications for tumour immunology; colorectal cancer cells might be a target for cytotoxic T-lymphocytes, however the tumour cells are not able to initiate an immune response. Stimulation of the immune system could possible be obtained using dendritic cells cultured in vitro and loaded with tumour antigens.
KeywordsSurvival rate Colorectal cancer Tumour infiltrating lymphocytes CD4+/CD8+ ratio HLA class II
The authors thank Mrs. K. Kejling for excellent technical assistance. We also thank the Department of Clinical Immunology, Odense University Hospital, for use of laboratory facilities. This work was supported by the Danish Cancer Society, The P Carl Petersen Foundation, University of Southern Denmark, the Danish Medical Association Research Fund, Lunds Foundation, The Novo Nordisk Foundation and Skovgaards Foundation, Denmark.
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