Prognostic Significance of Tumor Chronic Inflammatory Infiltrate in Diffuse Malignant Mesothelioma.
Wanghai Zhang, Maria McIntire, Raphael Bueno, John Godleski, Lucian Chirieac. Brigham and Women's Hospital, Boston, MA; Caris Life Science, Newton, MA
Background: Diffuse malignant mesothelioma is well known to be an aggressive disease. Therefore, identification of histopathologic factors with prognostic value is important for selection of therapeutic modalities. Recent studies in other malignancies have shown that the tumor inflammatory infiltrate has important prognostic value. The aim of the present study was to investigate whether the tumor stromal inflammatory infiltrate represented by CD3 positive cells is a prognostic factor in patients with diffuse malignant mesothelioma.
Design: We studied 204 patients with diffuse malignant mesothelioma (125 epithelioid, 8 sarcomatoid, and 71 biphasic type) who had surgical resection performed at Brigham and Women's Hospital between 2001 and 2008. Paraffin embedded tumor samples were used to construct tissue microarrays. CD3 positivity was evaluated and graded in each tumor as absent (<1%), moderate (<50%), or severe (>50%). Patient age, sex, tumor type, TNM stage, lymphovascular invasion and number of positive lymph nodes were recorded and correlated with CD3 positivity.
Results: In our study, 166 patients (81%) were men and 38 (19%) were women with mean age 63.2 (range 34-84). T category was 1 in 4% of patients, 2 in 24%, 3 in 43% and 4 in 29%. We found that a higher number of CD3 positive lymphocytes were correlated with fewer mediastinal lymph node metastases (p=0.002).
Conclusions: Our results suggest that the degree of chronic inflammatory infiltrate in diffuse malignant mesothelioma has prognostic value. Chronic inflammatory infiltrate may represent an important parameter in the histopathologic assessment of diffuse malignant mesothelioma. An increased number of CD3 positive lymphocytes are associated with fewer lymph node metastases. Stromal chronic inflammatory infiltrate should be considered in the planning of the management of patients with diffuse malignant mesothelioma.
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 283, Tuesday Morning