title: CD8+ tumor-infiltrating lymphocytes together with CD4+ tumor-infiltrating lymphocytes and dendritic cells improve the prognosis of patients with pancreatic adenocarcinoma.
abstract: OBJECTIVE
  Recent studies have demonstrated the importance of tumor immunity for a cancer patient's prognosis. In some types of cancer, it has been shown through immunohistochemical analysis that the existence of CD8+ tumor-infiltrating lymphocytes (TILs) is a crucial factor in determining prognosis. In an experimental model, CD4+ lymphocytes together with CD8+ lymphocytes contributed significantly to tumor immunity.
  
  
  METHODS
  Specimens were taken from 80 surgically resected pancreatic adenocarcinomas between 1992 and 1999. Immunohistochemical staining of CD4, CD8, and S100 protein was performed, and the levels of these proteins were determined by microscopic analysis. The percentages of patients in the CD4(+) and CD8(+) groups were 59% (47/80) and 25% (16/80), respectively. When separated into 4 groups, CD4/8(+/+), CD4/8(+/-), CD4/8(-/+) and CD4/8(-/-), the overall survival rate was significantly higher in CD4/8(+/+) patients (13 cases) compared with those in all other groups combined (67 cases; P = 0.0098). CD4/8(+/+) status was negatively correlated with tumor depth and TNM stage. Multivariate analyses showed that CD4/8(+/+) status was an independent favorable prognostic factor. The number of tumor-infiltrating S100 protein positive cells was also significantly higher in the CD4/8(+/+) group than in others (P = 0.0084).
  
  
  CONCLUSIONS
  In pancreatic adenocarcinoma, the presence of CD4+ TILs together with CD8+ TILs serves as a good indicator of the patient's outcome after surgical treatment.
authors.affiliation: Division of Cancer Medicine, Cancer Medicine, and Surgical Oncology, Hokkaido University Graduate School of Medicine, Sapporo, Japan. fuku@med.hokudai.ac.jp
authors.forename: Akira
authors.initials: A
authors.lastname: Fukunaga
authors.forename: Masaki
authors.initials: M
authors.lastname: Miyamoto
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Cho
authors.forename: Soichi
authors.initials: S
authors.lastname: Murakami
authors.forename: You
authors.initials: Y
authors.lastname: Kawarada
authors.forename: Taro
authors.initials: T
authors.lastname: Oshikiri
authors.forename: Kentaro
authors.initials: K
authors.lastname: Kato
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: Tomoo
authors.initials: T
authors.lastname: Itoh
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Morikawa
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: D000230:Adenocarcinoma / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015704:CD4 Antigens / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D016827:CD8 Antigens / Q000032:analysis; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D002452:Cell Count; D003713:Dendritic Cells / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000737:chemistry / Q000276:immunology / Q000473:pathology; D010190:Pancreatic Neoplasms / Q000276:immunology / Q000378:metabolism / Q000473:pathology*; D011379:Prognosis
chemical_list: D015704:CD4 Antigens; D016827:CD8 Antigens