Skip to main content

Advertisement

Log in

CD8+ tumor-infiltrating lymphocytes predict favorable prognosis in malignant pleural mesothelioma after resection

  • Original Article
  • Published:
Cancer Immunology, Immunotherapy Aims and scope Submit manuscript

Abstract

Defects in human leukocyte antigen (HLA) class I expression may allow tumor cells to escape immune recognition. T cell infiltration is associated with a good prognosis in many cancers. However, the role of HLA class I expression and tumor-infiltrating lymphocytes (TILs) in malignant pleural mesothelioma (MPM) has not been fully analyzed. In the present study, we investigated the immune profiles and conducted outcome analyses of MPM patients. HLA class I expression and TILs (CD4+, CD8+, and NK cells) were detected by immunohistochemistry in a series of 44 MPM cases. To detect HLA class I expression, specimens were stained with the anti-pan HLA class I monoclonal antibody EMR8-5. The expression of HLA class I was positive in all patients. There was no case that showed negative HLA class I expression. The density of CD4+ and CD8+ TILs were strongly correlated (R = 0.76, p < 0.001). A high density of CD8+ TILs was a significantly better prognostic factor for the survival of patients with extrapleural pneumonectomy (p < 0.05). Multivariate analysis revealed that a high density of CD8+ TILs is an independent prognostic factor for patients who underwent extrapleural pneumonectomy. The presence of intratumoral CD8+ T cells was correlated with an improved clinical outcome, raising the possibility that CD8+ T cells might play a pivotal role in the antitumor immune response against MPMs. Thus, the stimulation of CD8+ lymphocytes might be an efficacious immunotherapy for MPM patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Abbreviations

HLA:

Human leukocyte antigen

TILs:

Tumor-infiltrating lymphocytes

MPM:

Malignant pleural mesothelioma

References

  1. Robinson BW, Musk AW, Lake RA (2005) Malignant mesothelioma. Lancet 366:397–408

    Article  CAS  PubMed  Google Scholar 

  2. Murayama T, Takahashi K, Natori Y, Kurumatani N (2006) Estimation of future mortality from pleural malignant mesothelioma in Japan based on an age-cohort model. Am J Ind Med 49:1–7

    Article  PubMed  Google Scholar 

  3. Hodgson JT, McElvenny DM, Darnton AJ, Price MJ, Peto J (2005) The expected burden of mesothelioma mortality in Great Britain from 2002 to 2050. Br J Cancer 92:587–593

    CAS  PubMed  Google Scholar 

  4. Robinson BWS, Lake RA (2005) Advances in malignant mesothelioma. N Engl J Med 353:1591–1603

    Article  CAS  PubMed  Google Scholar 

  5. Sugerbaker DJ, Jaklitsch MT, Bueno R, Richards W, Lukanich J, Mentzer SJ, Colson Y, Linden P, Chang M, Capalbo L, Oldread E, Neragi-Miandoab S et al (2004) Prevention, early detection, and management of complications after 328 consecutive extrapleural pneumonectomies. J Thorac Cardiovasc Surg 128:138–146

    Article  Google Scholar 

  6. Vogelzang JN, Rusthoven JJ, Symanowski J, Denham C, Kaukel E, Ruffie P, Gatzemeier U, Boyer M, Emri S, Manegold C, Niyikiza C, Paoletti P (2003) Phase III study of pemetrexed in combination with cisplatin versus cisplatin alone in patients with malignant pleural mesothelioma. J Clin Oncol 21:2636–2644

    Article  CAS  PubMed  Google Scholar 

  7. Ahamad A, Stevens CW, Smythe WR, Liao Z, Vaporciyan AA, Rice D, Walsh G, Guerrero T, Chang J, Bell B, Komaki R, Forster KM (2003) Promising early local control of malignant pleural mesothelioma following postoperative intensity modulated radiotherapy (IMRT) to the chest. Cancer J 9:476–484

    Article  PubMed  Google Scholar 

  8. Naito Y, Saito K, Shiiba K, Ohuchi A, Saigenji K, Nagura H, Ohtani H (1998) CD8+ T cells infiltrated within cancer cell nests as a prognostic factor in human colorectal cancer. Cancer Res 58:3491–3494

    CAS  PubMed  Google Scholar 

  9. Zhang L, Conejo-Garcia JR, Katsaros D, Gimotty PA, Massobrio M, Regnani G, Makrigiannakis A, Gray H, Schlienger K, Liebman MN, Rubin SC, Coukos G (2003) Intratumoral T cells, recurrence, and survival in epithelial ovarian cancer. N Engl J Med 348:203–213

    Article  CAS  PubMed  Google Scholar 

  10. Schumacher K, Haensch W, Roefzaad C, Schlag PM (2001) Prognostic significance of activated CD8(+) T cell infiltrations within esophageal carcinomas. Cancer Res 61:3932–3936

    CAS  PubMed  Google Scholar 

  11. Hosch SB, Meyer AJ, Schneider C, Stoecklein N, Prenzel KL, Pantel K, Broelsch CE, Izbicki JR (1997) Expression and prognostic significance of HLA class I, ICAM-1, and tumor-infiltrating lymphocytes in esophageal cancer. J Gastrointest Surg 1:316–323

    Article  CAS  PubMed  Google Scholar 

  12. Madjd Z, Spendlove I, Pinder SE, Ellis IO, Durrant LG (2005) Total loss of MHC class I is an independent indicator of good prognosis in breast cancer. Int J Cancer 117:248–255

    Article  CAS  PubMed  Google Scholar 

  13. Kikuchi E, Yamazaki K, Torigoe T, Cho Y, Miyamoto M, Oizumi S, Hommura F, Dosaka-Akita H, Nishimura M (2007) HLA class I antigen expression is associated with a favorable prognosis in early stage non-small cell lung cancer. Cancer Sci 98:1424–1430

    Article  CAS  PubMed  Google Scholar 

  14. Rusch VW (1995) A proposed new international TNM staging system for malignant pleural mesothelioma. From the International Mesothelioma Interest Group. Chest 108:1122–1128

    Article  CAS  PubMed  Google Scholar 

  15. Schmacher K, Haensch W, Roefzaad C, Schlag PM (2001) Prognostic significance of activated CD8+ T cell infiltration within esophageal carcinomas. Cancer Res 61:3932–3936

    Google Scholar 

  16. Cho Y, Miyamoto M, Kato K, Fukunaga A, Shichinohe T, Kawarada Y, Hida Y, Oshikiri T, Kurokawa T, Suzuoki M, Nakakubo Y, Hiraoka K et al (2003) CD4+ and CD8+ T cells cooperate to improve prognosis of patients with esophageal squamous cell carcinoma. Cancer Res 63:1555–1559

    CAS  PubMed  Google Scholar 

  17. Sato E, Olson HS, Ahn J, Bundy B, Nishikawa H, Qian F, Jungbluth AA, Frosina D, Gnjatic S, Ambrosone C, Kepner J, Odunsi T et al (2005) Intraepithelial CD8+ tumor-infiltrating lymphocytes and a high CD8+/regulatory T cell ratio are associated with favorable prognosis in ovarian cancer. Proc Natl Acad Sci USA 102:18538–18543

    Article  CAS  PubMed  Google Scholar 

  18. Gao Q, Qiu SJ, Fan J, Zhou J, Wang XY, Xiao YS, Xu Y, Li YW, Tang ZY (2007) Intratumoral balance of regulatory and cytotoxic T cells is associated with prognosis of hepatocellular carcinoma after resection. J Clin Oncol 25:2586–2593

    Article  PubMed  Google Scholar 

  19. Nakano O, Sato M, Naito Y, Suzuki K, Orikasa S, Aizawa M, Suzuki Y, Shintaku I, Nagura H, Ohtani H (2001) Proliferative activity of intratumoral CD8+ T-lymphocytes as a prognostic factor in human renal cell carcinoma: clinicopathologic demonstration of antitumor immunity. Cancer Res 61:5132–5136

    CAS  PubMed  Google Scholar 

  20. Wakabayashi O, Yamazaki K, Oizumi S, Hommura F, Kinoshita I, Ogura S, Dosaka-Akita H, Nishimura M (2003) CD4+ T cells in cancer stroma, not CD8+ T cells in cancer cell nests, are associated with favorable prognosis in human non-small cell lung cancers. Cancer Sci 94:1003–1009

    Article  CAS  PubMed  Google Scholar 

  21. Harlin H, Meng Y, Peterson AC, Zha Y, Tretiakova M, Slingluff C, McKee M, Gajewski TF (2009) Chemokine expression in melanoma metastases associated with CD8+ T-cell recruitment. Cancer Res 69:3077–3085

    Article  CAS  PubMed  Google Scholar 

  22. Leigh AR, Webster I (1982) Lymphocytic infiltration of pleural mesothelioma and its significance for survival. S Afr Med J 61:1007–1009

    CAS  PubMed  Google Scholar 

  23. Mudhar SH, Fisher MP, Wallace HAW (2002) No relationship between tumour infiltrating lymphocytes and overall survival is seen in malignant mesothelioma of the pleura. EJSO 28:564–566

    Article  CAS  PubMed  Google Scholar 

  24. Anraku M, Cunningham SK, Yun Z, Tsao MS, Zhang L, Keshavjee S, Johnston MR, de Perrot M (2008) Impact of tumor-infiltrating T cells on survival in patients with malignant pleural mesothelioma. J Thorac Cardiovasc Surg 135:823–829

    Article  PubMed  Google Scholar 

  25. Marincola MF, Jaffee ME, Hicklin JD, Ferrone S (2000) Escape of human solid tumors from T-cell recognition: molecular mechanisms and functional significance. Adv Immunol 74:181–273

    Article  CAS  PubMed  Google Scholar 

  26. Redondo M, Ruiz-Cabello F, Concha A, Cabrera T, Pérez-Ayala M, Oliva MR, Garrido F (1991) Altered HLA class I expression in non-small cell lung cancer is independent of c-myc activation. Cancer Res 51:2463–2468

    CAS  PubMed  Google Scholar 

  27. Korkolopoulou P, Kaklamanis L, Pezzella F, Harris AL, Gatter KC (1996) Loss of antigen-presenting molecules (MHC class I and TAP-1) in lung cancer. Br J Cancer 73:148–153

    CAS  PubMed  Google Scholar 

  28. Romnath N, Tan D, Li Q, Hylander BL, Bogner P, Ryes L, Ferrone S (2006) Is downregulation of MHC class I antigen expression in human non-small cell lung cancer associated with prolonged survival? Cancer Immunol Immunother 55:891–899

    Article  Google Scholar 

  29. Tsukahara T, Kawaguchi S, Torigoe T, Asanuma H, Nakazawa E, Shimozawa K, Nabeta Y, Kimura S, Kaya M, Nagoya S, Wada T, Yamashita T et al (2006) Prognostic significance of HLA class I expression in osteosarcoma defined by anti-pan HLA class I monoclonal antibody, EMR8-5. Cancer Sci 97:1374–1380

    Article  CAS  PubMed  Google Scholar 

  30. Oudejans JJ, Harijadi H, Kummer JA, Tan IB, Bloemena E, Middeldorp JM, Bladergroen B, Dukers DF, Vos W, Meijer CJ (2002) High numbers of granzyme B/CD8-positive tumour-infiltrating lymphocytes in nasopharyngeal carcinoma biopsies predict rapid fatal outcome in patients treated with curative intent. J Pathol 198:468–475

    Article  PubMed  Google Scholar 

  31. Keene JA, Forman J (1982) Helper activity is required for the in vivo generation of cytotoxic T lymphocytes. J Exp Med 155:768–782

    Article  CAS  PubMed  Google Scholar 

  32. Zou W (2006) Regulatory T cells, tumour immunity and immunotherapy. Nat Rev Immunol 6:295–307

    Article  CAS  PubMed  Google Scholar 

  33. Davidson JA, Musk AW, Wood BR, Morey S, Ilton M, Yu LL, Drury P, Shilkin K, Robinson BW (1998) Intralesional cytokine therapy in cancer: a pilot study of GM-CSF infusion in mesothelioma. J Immunother 21:389–398

    Article  CAS  PubMed  Google Scholar 

  34. Castagneto B, Zai S, Mutti L, Lazzaro A, Ridolfi R, Piccolini E, Ardizzoni A, Fumagalli L, Valsuani G, Botta M (2001) Palliative and therapeutic activity of IL-2 immunotherapy in unresectable malignant pleural mesothelioma with pleural effusion: results of a phase II study on 31 consecutive patients. Lung Cancer 31:303–310

    Article  CAS  PubMed  Google Scholar 

  35. Robinson BWS, Bowman R, Christmas T, Musk AW, Manning LS (1991) Immunotherapy for malignant mesothelioma: use of interleukin-2 and interferon alpha. Interferons Cytokines 18:5–7

    Google Scholar 

  36. Hassan R, Bullock S, Premkumar A, Kreitman RJ, Kindler H, Willingham MC, Pastan I (2007) Phase I study of SS1P, a recombinant anti-mesothelin immunotoxin given as a bolus i.v. infusion to patients with mesothelin-expressing mesothelioma, ovarian, and pancreatic cancers. Clin Cancer Res 13:5144–5149

    Article  CAS  PubMed  Google Scholar 

  37. Kreitman RJ, Hassan R, FitzGerald DJ, Pastan I (2009) Phase I trial of continuous infusion anti-mesothelin recombinant immunotoxin SS1P. Clin Cancer Res 15:5274–5279

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to Dr Koichi Yamazaki, former associate professor of the First Department of Medicine, Hokkaido University School of Medicine, for his outstanding support. This study was supported by Grant-in-Aid from the Ministry of Health, Labor and Welfare of Japan.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Satoshi Oizumi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Yamada, N., Oizumi, S., Kikuchi, E. et al. CD8+ tumor-infiltrating lymphocytes predict favorable prognosis in malignant pleural mesothelioma after resection. Cancer Immunol Immunother 59, 1543–1549 (2010). https://doi.org/10.1007/s00262-010-0881-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00262-010-0881-6

Keywords

Navigation