title: CD4+ and CD8+ T cells cooperate to improve prognosis of patients with esophageal squamous cell carcinoma.
abstract: The purpose of this study is to clarify the roles of immune cell types, both individually and synergistically, in esophageal squamous cell carcinoma (ESCC). One hundred and twenty-two patients (105 males and 17 females; mean age, 62.3 years) with primary ESCC underwent surgical tumor resection at the Department of Surgical Oncology, School of Medicine, Hokkaido University and two affiliated hospitals between 1989 and 1999. Immunohistochemical analyses were performed for CD4, CD8, and CD57 (surface markers for natural killer cells). Patient prognosis was found to correlate with the number of CD4(+) and CD8(+) T cells in the stroma and the number of CD8(+) T cells within the cancer cell nest. Furthermore, the number of CD8(+) T cells in the stroma and within the cancer cell nest was found to be correlated [correlation coefficient (r) = 0.790; P < 0.0001). However, no correlation was observed between the number of natural killer cells and patient prognosis. Patients were classified into the following four groups based on CD4(+) and CD8(+) T-cell count: CD4/8(+/+), CD4/8(+/-), CD4/8(-/+), CD4/8(-/-). For the general patient pool, as well as for selected p-stage III and IV cases (n = 48), the survival rate for CD4/8(+/+) patients was significantly higher than that for the other three groups (log-rank test, P = 0.0012 and 0.0088, respectively). Multivariate analysis identified CD4/8(+/+) status, T classification, and N classification as independent prognostic factors. In conclusion, cooperation between CD4(+) and CD8(+) T cells correlates strongly with ESCC patient prognosis.
authors.affiliation: Division of Cancer Medicine, Hokkaido University Graduate School of Medicine, Hokkaido 060-8638, Japan. c-yasu@rc4.so-net.ne.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Cho
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kato
authors.forename: Akira
authors.initials: A
authors.lastname: Fukunaga
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shichinohe
authors.forename: You
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hida
authors.forename: Taro
authors.initials: T
authors.lastname: Oshikiri
authors.forename: Takanori
authors.initials: T
authors.lastname: Kurokawa
authors.forename: Masato
authors.initials: M
authors.lastname: Suzuoki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Nakakubo
authors.forename: Kei
authors.initials: K
authors.lastname: Hiraoka
authors.forename: Soichi
authors.initials: S
authors.lastname: Murakami
authors.forename: Toshiya
authors.initials: T
authors.lastname: Shinohara
authors.forename: Tomoo
authors.initials: T
authors.lastname: Itoh
authors.forename: Shunichi
authors.initials: S
authors.lastname: Okushiba
authors.forename: Satoshi
authors.initials: S
authors.lastname: Kondo
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Katoh
mesh_terms: D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology*; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000473:pathology; D002470:Cell Survival / Q000276:immunology; D004938:Esophageal Neoplasms / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007694:Killer Cells, Natural / Q000276:immunology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D017154:Stromal Cells / Q000276:immunology; D015996:Survival Rate