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Decreased CD8+ Lymphocytic Infiltration in Multifocal and Multicentric Glioblastomas
Run Wang1,2, Yifu Song1, Tianhao Hu1
1Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China.
Purpose:
Multifocal and multicentric glioblastomas (mGBMs) are associated with a poorer prognosis compared to unifocal glioblastoma (uGBM). The presence of CD8+ tumor-infiltrating lymphocytes (TILs) is predictive of clinical outcomes in human malignancies. Here, we examined the CD8+ lymphocytic infiltration in mGBMs.
Methods:
The clinical data of 57 consecutive IDH wildtype primary mGBM patients with histopathological diagnoses were retrospectively reviewed. CD8+ TILs were quantitatively evaluated by immunohistochemical staining. The survival function of CD8+ TILs was assessed by Kaplan-Meier analysis and Cox proportional hazard models.
Results:
No significant difference in the concentration of CD8+ TILs was observed among foci from the same patient (P>0.150). The presence of CD8+ TILs was similar between multifocal and multicentric GBMs (P=0.885). The concentration of CD8+ TILs was significantly lower in mGBMs than in uGBMs (P=0.002). In mGBM patients, the CD8+ TIL level was associated with preoperative KPS (P=0.018). The median overall survival (OS) of the 57 mGBMs was 9 months. A low CD8+ TIL level (multivariate HR 4.404, 95% CI 1.954-9.926, P=0.0004) was an independent predictor of poor OS, while postoperative temozolomide chemotherapy (multivariate HR 6.076, 95% CI 2.330-15.842, P=0.0002) was independently associated with prolonged OS in mGBMs.
Conclusions:
Decreased CD8+ TIL levels potentially correlate with unfavorable clinical outcome in mGBMs, suggesting an influence of the local immuno-microenvironment on the progression of mGBMs.
Insights
Low CD8+ tumor-infiltrating lymphocytes (TILs) in multifocal glioblastomas (mGBMs) correlate with poor prognosis. This study highlights the role of the tumor microenvironment in mGBM progression, suggesting TILs as a potential prognostic marker.
Area of Science:
- Neuro-oncology
- Immunology
- Cancer Research
Background:
- Multifocal and multicentric glioblastomas (mGBMs) present a poorer prognosis than unifocal glioblastoma (uGBM).
- CD8+ tumor-infiltrating lymphocytes (TILs) are established predictors of clinical outcomes in various cancers.
- The role of CD8+ TILs in the distinct microenvironment of mGBMs requires further investigation.
Purpose of the Study:
- To investigate the quantitative presence and prognostic significance of CD8+ TILs in multifocal and multicentric glioblastomas (mGBMs).
- To compare CD8+ TIL infiltration levels between mGBMs and unifocal glioblastomas (uGBMs).
- To assess the association of CD8+ TIL levels with clinical parameters and overall survival in mGBM patients.
Main Methods:
- Retrospective review of clinical data from 57 IDH wildtype primary mGBM patients.
- Quantitative evaluation of CD8+ TILs using immunohistochemical staining.
- Survival analysis employing Kaplan-Meier and Cox proportional hazard models.
Main Results:
- CD8+ TIL concentration was similar across different foci within the same mGBM and between multifocal and multicentric subtypes.
- mGBMs exhibited significantly lower CD8+ TIL concentrations compared to uGBMs.
- Low CD8+ TIL levels independently predicted poor overall survival (OS) in mGBM patients (HR 4.404).
- Postoperative temozolomide chemotherapy was independently associated with prolonged OS (HR 6.076).
Conclusions:
- Decreased CD8+ TIL levels in mGBMs are associated with unfavorable clinical outcomes.
- The local immune microenvironment, indicated by CD8+ TILs, appears to influence mGBM progression.
- CD8+ TILs may serve as a valuable prognostic biomarker for mGBM patients.
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