title: Prognostic significance of activated CD8(+) T cell infiltrations within esophageal carcinomas.
abstract: The purpose of this study was to explore whether there is a linkage between the infiltration of CD8(+) T cells and the risk of death from esophageal cancer. Cases of 70 consecutive patients in whom esophageal squamous cell carcinomas ( n = 33) or adenocarcinomas (n = 37) were R0-resected between 1993 and 1999 were reviewed. The presence of activated CD8(+) T cells was evaluated by quantitative real-time PCR and immunohistochemistry and compared to clinical and pathological stages. The primary end point analyzed was overall survival, and a multivariate analysis was performed to distinguish any factors conferring an improved survivorship. Intratumoral (i.t.) CD8(+) T cells accumulating within the epithelial complexes were detected in 11 of all (16%) cases: in 9 of 25 (36%) patients with Union Internationale Contrele Cancer stage I or II versus 2 of 45 (4%) patients with Union Internationale Contrele Cancer stage III or IV (P = 0.001). Intratumoral CD8(+) T cell infiltrations showed proliferative activity and also IFN-gamma secretion. The presence of i.t. CD8(+) T cell infiltration more than peritumoral infiltration was associated with a good prognosis in both squamous cell and adenocarcinomas. Multivariate analysis showed that i.t. CD8(+) T cell infiltration was an independent prognostic factor (hazard ratio, 0.5; P = 0.0004) indicating favorable outcome. In conclusion, the presence of CD8(+) T cell infiltration in esophageal carcinomas is a favorable prognostic factor that should have diagnostic and therapeutic implications.
authors.affiliation: Department of Surgery and Surgical Oncology, Charité, Humboldt University of Berlin, Lindenberger Weg 80, 13122 Berlin, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Schumacher
authors.forename: W
authors.initials: W
authors.lastname: Haensch
authors.forename: C
authors.initials: C
authors.lastname: Röefzaad
authors.forename: P M
authors.initials: PM
authors.lastname: Schlag
mesh_terms: D000230:Adenocarcinoma / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000276:immunology*; D004938:Esophageal Neoplasms / Q000276:immunology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008213:Lymphocyte Activation / Q000276:immunology; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012044:Regression Analysis; D016019:Survival Analysis