title: T cell density and location can influence the prognosis of ovarian cancer.
abstract: The aims of this study were to examine the significance of CD3+ cells in patients with epithelial ovarian cancer and to determine their influence on the disease in relation to their location within tumours. A 157-core tissue-microarray constructed from primary ovarian cancer patients treated at Nottingham-University-Hospitals (2000-2007) was stained for the T-cell marker CD3. The number of CD3+ cells in direct contact with tumour cells was counted per tumour area. These were considered as "intra-tumoural T-cells (ITTC)". Cores were divided into CD3 'high' or 'low' density tumours. "Stromal T-cells (STC)" were assigned as 'positive' or 'negative'. The study population had a median follow-up time of 36-months (0-75). The number of ITTC counted in tumour cores ranged between 0 and 184/mm(2). 90-tumours-(57%) were found to be in the "low-density" rubric, while 56-(36%) were of a "high-density" T-cell population. STC were found in 118-cores-(75%)-compared to 22-cores-(14%)-negative cores. Higher number of ITTC correlated with lower-grade-(p = 0.045), tumour-type-(p = 0.034), and longer-median-survival-times (57-versus 37-months for high-and low-ITTC densities, respectively, p = 0.038). This relationship was reversed when tumours were infiltrated by CD3+ cells in the stroma, predicting worse-survival (Log-rank-test, p = 0.028). Combining ITTC with STC produced an interesting pattern where the ITTC-low/STC + ve had the worst prognosis (p = 0.003). Infiltration of ovarian cancer by T-cells can influence its prognosis depending on the location of these cells (intra-tumoural-versus-stromal). The former predicts improved survival, while the latter is probably contributing to tumour progression and, in turn, worse survival.
authors.affiliation: Department of Clinical Oncology, Nottingham University Hospitals, NHS Trust-City Campus, Hucknall Road, Nottingham, UK.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Al-Attar
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shehata
authors.forename: Lindy
authors.initials: L
authors.lastname: Durrant
authors.forename: Paul
authors.initials: P
authors.lastname: Moseley
authors.forename: Suha
authors.initials: S
authors.lastname: Deen
authors.forename: Stephen
authors.initials: S
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017252:CD3 Complex; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008875:Middle Aged; D009367:Neoplasm Staging; D009375:Neoplasms, Glandular and Epithelial / Q000276:immunology* / Q000401:mortality / Q000473:pathology; D010051:Ovarian Neoplasms / Q000276:immunology* / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D013601:T-Lymphocytes; D046888:Tissue Array Analysis
chemical_list: D017252:CD3 Complex