Tumor infiltrating Foxp3+ regulatory T-cells are associated with recurrence in pathologic stage I NSCLC patients.
BACKGROUND
Early stage lung cancer has a variable prognosis, and there are currently no markers that predict which patients will recur. This study examined the relation between tumor-regulatory T (Treg) cells and total tumor-infiltrating T-cell lymphocytes (TIL) to determine whether they correlated with recurrence.


METHODS
The authors reviewed all patients in our tissue databank from 1996 to 2001 and identified 64 consecutive pathologic stage I non-small cell lung cancer (NSCLC) patients who had surgical resection and at least a 2.5 years disease-free follow-up or documented recurrence within 2 years. Immunohistochemical analyses were performed on paraffin-embedded lung cancer tissue and the relation between Treg cells, TIL, and disease-specific survival was determined. A risk index was devised deductively for various possible combinations of Treg cells and TIL.


RESULTS
Treg cells and TIL were detected in 33 of 64 (51%) and 53 of 64 (83%) patients, respectively. When data were analyzed by using a Treg/TIL Combination Risk Index, patients with high-risk and intermediate-risk indices had hazard ratios of 8.2 (P = .007) and 3.3 (P = .109), respectively.


CONCLUSIONS
Patients with stage I NSCLC who have a higher proportion of tumor Treg cells relative to TIL had a significantly higher risk of recurrence. These data may be useful, particularly if combined with a panel of tumor markers, to suggest at the time of diagnosis which patients with seemingly early-stage NSCLC will relapse.
Petersen
Rebecca P
RP
Department of Surgery, Duke University Medical Center, Durham, North Carolina 27710, USA.
Campa
Michael J
MJ
Sperlazza
Justin
J
Conlon
Debbi
D
Joshi
Mary-Beth
MB
Harpole
David H
DH
Patz
Edward F
EF
D017252:CD3 Complex / Q000032:analysis; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D051858:Forkhead Transcription Factors / Q000032:analysis*; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D016246:Lymphocytes, Tumor-Infiltrating / Q000737:chemistry / Q000276:immunology*; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D050378:T-Lymphocytes, Regulatory / Q000737:chemistry / Q000276:immunology*
D017252:CD3 Complex; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors