title: Tumor MHC class I expression improves the prognostic value of T-cell density in resected colorectal liver metastases.
abstract: Tumor-infiltrating lymphocytes (TIL) in colorectal cancer liver metastases (CLM) have been associated with more favorable patient outcomes, but whether MHC class I (MHC-I) expression on cancer cells affects prognosis is uncertain. Immunohistochemistry was performed on a tissue microarray of 158 patients with CLM, who underwent partial hepatectomy with curative intent. Using the antibody HC-10, which detects HLA-B and HLA-C antigens and a minority of HLA-A antigens, MHC-I expression was correlated with β-2 microglobulin (β2m; r = 0.7; P < 0.001), but not with T-cell density (r < 0.32). The median follow-up for survivors was 9.7 years. High levels of MHC-I expression in tumors concomitant with high T-cell infiltration (CD3, CD4, or CD8) best identified patients with favorable outcomes, compared with patients with one or none of these immune features. The median overall survival (OS) of patients with MHC-I(hi)CD3(hi) tumors (n = 31) was 116 months compared with 40 months for the others (P = 0.001), and the median time to recurrence (TTR) was not reached compared with 17 months (P = 0.008). By multivariate analysis, MHC(hi)CD3(hi) was associated with OS and TTR independent of the standard clinicopathologic variables. An immune score that combines MHC-I expression and TIL density may be a valuable prognostic tool in the treatment of patients with CLM.
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island simon.turcotte.1@umontreal.ca.
authors.forename: Simon
authors.initials: S
authors.lastname: Turcotte
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Katz
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Jinru
authors.initials: J
authors.lastname: Shia
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: William R
authors.initials: WR
authors.lastname: Jarnagin
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: T Peter
authors.initials: TP
authors.lastname: Kingham
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Allen
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Yuman
authors.initials: Y
authors.lastname: Fong
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Michael I
authors.initials: MI
authors.lastname: D'Angelica
authors.affiliation: Authors' Affiliations: Departments of Surgery and Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York; and Department of Surgery, Boston University School of Medicine, Roger Williams Medical Center, Providence, Rhode Island.
authors.forename: Ronald P
authors.initials: RP
authors.lastname: DeMatteo
mesh_terms: D017252:CD3 Complex / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000276:immunology*; D005260:Female; D006498:Hepatectomy / Q000401:mortality; D015395:Histocompatibility Antigens Class I / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000276:immunology* / Q000401:mortality / Q000556:secondary; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D013601:T-Lymphocytes / Q000276:immunology*; D001613:beta 2-Microglobulin / Q000378:metabolism
chemical_list: D017252:CD3 Complex; D015395:Histocompatibility Antigens Class I; D001613:beta 2-Microglobulin