A morphological and immunophenotypic map of the immune response in Merkel cell carcinoma

被引:32
作者
Walsh, Noreen M. [1 ,2 ,3 ]
Fleming, Kirsten E. [1 ,2 ]
Hanly, John G. [1 ,2 ,3 ]
Hache, Kelly Dakin [1 ,2 ]
Doucette, Steve [2 ,4 ]
Ferrara, Gerardo [5 ,6 ]
Cerroni, Lorenzo [6 ]
机构
[1] Nova Scotia Hlth Author Cent Zone, Queen Elizabeth II Hlth Sci Ctr, Dept Pathol, Halifax, NS B3H 1V8, Canada
[2] Dalhousie Univ, Halifax, NS B3H 1V8, Canada
[3] Nova Scotia Hlth Author Cent Zone, Queen Elizabeth II Hlth Sci Ctr, Dept Med, Halifax, NS B3H 1V8, Canada
[4] Dalhousie Univ, Dept Community Hlth & Epidemiol, Res Methods Unit, Halifax, NS B3H 1V7, Canada
[5] Gaetano Rummo Hosp, Anat Pathol Unit, Benevento, Italy
[6] Med Univ Graz, Dept Dermatol, Res Unit Dermatopathol, Graz, Austria
关键词
Merkel cell carcinoma; Cutaneous neuroendocrine carcinoma; Tumor-infiltrating lymphocytes; TILS; Tumor-specific CD8+T cells; PD-1/PD-L1; pathway; Antitumoral immunity; T-CELLS; INDEPENDENT PREDICTOR; POLYOMAVIRUS; EXPRESSION; REGRESSION; SURVIVAL; PD-L1;
D O I
10.1016/j.humpath.2016.02.002
中图分类号
R36 [病理学];
学科分类号
100104 ;
摘要
The susceptibility of Merkel cell carcinoma to the host immune response has prompted a search for effective immunotherapy. CD8-positive T lymphocytes are considered key effectors of this response, but the cellular infiltrates also harbor tumor-protective agents. By developing a comprehensive morphological and immunophenotypic map of tumor-infiltrating lymphocytes (11LS) in Merkel cell carcinoma, we aimed to establish a useful template for future studies. Twenty-two cases (mean age, 79 years [range, 52-95]; male-female ratio, 10:12) were studied. TILS were categorized as brisk (7), nonbrisk (9), and absent(6). Merkel cell polyomavirus (MCPyV) positive (16) and -negative (6) cases were included, as were those with pure (18) and combined (4) morphologies. One MCPyV+ case had undergone spontaneous regression. Immunohistochemical markers included CD3, CD4, CD8, CD20, CD68, FoxP3, PD-1, and CD123. Statistical analysis used Fisher exact tests and Spearman correlations. There was a significant correlation between brisk TILs and MCPyV+ status (P =.025). CD8+ T lymphocytes predominated, were present in significantly higher proportions in brisk infiltrates (P =.003), and showed a significant predilection for the intratumoral environment (P =.003) Immune inhibitors including T regulatory cells (FOXP3+) and PD-1+ "exhausted" immunocytes were present in lower proportions. Our findings support (1) the link between a brisk immune response and MCPyV positivity, (2) the supremacy of CD8+ cells in effecting immunity, and (3) the incorporation of immune inhibitors within the global infiltrate. Efforts to therapeutically arm the "effectors" and disarm the "detractors" are well focused. These will likely have the greatest impact on MCPyV-positive cases. (C) 2016 Elsevier Inc. All rights reserved.
引用
收藏
页码:190 / 196
页数:7
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