Prognostic markers of inflammation in endometrioid and clear cell ovarian cancer

Alejandro Gallego, Marta Mendiola, Barbara Hernando, Bárbara Hernando, Alberto Berjón, Alberto Berjon, Alice Cádiz, Alice Cadiz, Blas Chaves-Urbano, Victoria Heredia-Soto, Spagnolo E, Emanuela Spagnolo, Hernández Gutiérrez A, Alicia Hernández, Alicia Hernández Gutiérrez, David Hardisson, Macintyre G, Geoff Macintyre, Redondo A, Andrés Redondo, Andres Redondo, Maria Jose Garcia, María J. García
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2022 · vol. 32(8) , pp. 1009–1016 · doi:10.1136/ijgc-2022-003353 · PMID:35437272 · W4223999099
article OA: closed CC0 ⤵ 2 in-corpus citations
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This paper identified prognostic markers of inflammation within endometrioid and clear cell ovarian cancer subtypes.

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Abstract

ObjectivesCancer-related systemic inflammation has been associated with prognosis in multiple cancer types. Conversely, local inflammation, which is characterized by dense intratumoral immune infiltrates, is a favorable predictor of survival outcome. However, these survival associations are not well established in ovarian cancer, particularly in the less frequent endometrioid and clear cell endometriosis associated histotypes.MethodsThis retrospective study included 119 patients (63 endometrioid and 56 clear cell ovarian carcinomas). We performed a comprehensive survival association analysis of both systemic (neutrophil-to-lymphocyte ratio or presence of endometriosis) and local inflammation markers (CD3+ and CD8+ tumor infiltrating lymphocytes) using multivariate Cox proportional hazards models that account for confounding factors.ResultsMedium to high levels of intraepithelial CD8+ tumor infiltrating lymphocytes are associated with longer survival in endometrioid ovarian cancer (p=0.04). In addition, we found that intraepithelial CD8+ tumor infiltrating lymphocytes are prognostic in clear cell ovarian cancer (p=0.02), and that intraepithelial CD3+ tumor infiltrating lymphocytes are also associated with improved outcome (p=0.02). Furthermore, intratumoral CD3+ and CD8+ tumor infiltrating lymphocytes showed improved prognosis in the endometrioid subtype (p<0.1). No prognostic value was observed for systemic immune markers.ConclusionsIn this study, patients with endometrioid and clear cell ovarian cancer with moderate to high CD8+ and CD3+ intraepithelial tumor infiltrating lymphocytes had longer overall survival. Higher expression of intratumoral CD3+ and CD8+ tumor infiltrating lymphocytes also showed an improved outcome in endometrioid ovarian cancer. In contrast, systemic inflammation, evaluated by neutrophil-to-lymphocyte ratio or presence of endometriosis, did not have a prognostic impact in these histologic subtypes.

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Condition tags

endometriosis

MeSH descriptors

Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Adenocarcinoma, Clear Cell Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Carcinoma, Endometrioid Endometriosis Endometriosis

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