title: Prognostic impact of lymphocytes in soft tissue sarcomas.
abstract: OBJECTIVE
  The purpose of this study was to clarify the prognostic significance of lymphocyte infiltration in soft tissue sarcomas (STS). Prognostic markers in potentially curable STS should guide therapy after surgical resection. The immune status at the time of resection may be important, but the prognostic significance of tumor infiltrating lymphocytes is controversial as the immune system has conflicting roles during cancer development.
  
  
  METHODS
  Tissue microarrays from 249 patients with STS were constructed from duplicate cores of viable and representative neoplastic tumor areas. Immunohistochemistry was used to evaluate the CD3+, CD4+, CD8+, CD20+ and CD45+ lymphocytes in tumors.
  
  
  RESULTS
  In univariate analyses, increased numbers of CD4+ (P = 0.008) and CD20+ (P = 0.006) lymphocytes in tumor correlated significantly with an improved disease-specific survival (DSS) in patients with wide resection margins (n = 108). In patients with non-wide resection margins (n = 141) increased numbers of CD3+ (P = 0.028) lymphocytes in tumor correlated significantly with shorter DSS. In multivariate analyses, a high number of CD20+ lymphocytes (HR = 5.5, CI 95%  = 1.6-18.6, P = 0.006) in the tumor was an independent positive prognostic factor for DSS in patients with wide resections margins.
  
  
  CONCLUSIONS
  High density of CD20+ lymphocytes in STS with wide resection margins is an independent positive prognostic indicator for these patients. Further research is needed to define if CD20+ cells can modify tumors in a way that reduces disease progression and metastatic potential.
authors.affiliation: Department of Clinical Pathology, University Hospital of North Norway, Tromso, Norway. sveinung.sorbye@unn.no
authors.forename: Sveinung W
authors.initials: SW
authors.lastname: Sorbye
authors.forename: Thomas
authors.initials: T
authors.lastname: Kilvaer
authors.forename: Andrej
authors.initials: A
authors.lastname: Valkov
authors.forename: Tom
authors.initials: T
authors.lastname: Donnem
authors.forename: Eivind
authors.initials: E
authors.lastname: Smeland
authors.forename: Khalid
authors.initials: K
authors.lastname: Al-Shibli
authors.forename: Roy M
authors.initials: RM
authors.lastname: Bremnes
authors.forename: Lill-Tove
authors.initials: LT
authors.lastname: Busund
mesh_terms: D015703:Antigens, CD / Q000032:analysis*; D018951:Antigens, CD20; D014408:Biomarkers, Tumor / Q000032:analysis; D015496:CD4-Positive T-Lymphocytes / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D018655:Lymphocyte Count; D016246:Lymphocytes, Tumor-Infiltrating / Q000473:pathology*; D011379:Prognosis; D012509:Sarcoma / Q000175:diagnosis / Q000473:pathology*; D046888:Tissue Array Analysis
chemical_list: D015703:Antigens, CD; D018951:Antigens, CD20; D014408:Biomarkers, Tumor