title: Analysis of FoxP3+ T-regulatory cells and CD8+ T-cells in ovarian carcinoma: location and tumor infiltration patterns are key prognostic markers.
abstract: OBJECTIVE
  Tumor infiltrating CD4+CD25+FoxP3+ regulatory immune cells (Treg) have been associated with impaired anti-tumor immune response and unfavorable prognosis for patients affected by ovarian carcinoma, whereas CD8+ T-cells have been found to positively influence survival rates in a large panel of solid tumors. Recently, density, location and tumor infiltration patterns of the respective immune cell subtypes have been identified as key prognostic factors for different types of tumors.
  
  
  METHODS
  We stained 210 human ovarian carcinoma samples immunhistochemically for FoxP3 and CD8 to identify the impact different immune cell patterns have on generally accepted prognostic variables as well as on overall survival.
  
  
  RESULTS
  We found that FoxP3+ cells located within lymphoid aggregates surrounding the tumor were strongly associated with reduced survival time (P = 0.007). Central accumulation of CD8+ effector cells within the tumor bed shows a positive effect on survival (P = 0,001).
  
  
  CONCLUSIONS
  The distribution pattern of immune cells within the tumor environment strongly influences prognosis and overall survival time of patients with ovarian carcinoma.
authors.affiliation: Department of Pathology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Hermans
authors.affiliation: Center of Integrated Protein Science Munich (CIPS-M) Division of Clinical Pharmacology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: David
authors.initials: D
authors.lastname: Anz
authors.affiliation: Tumorregister Munich, Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Jutta
authors.initials: J
authors.lastname: Engel
authors.affiliation: Department of Pathology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Kirchner
authors.affiliation: Center of Integrated Protein Science Munich (CIPS-M) Division of Clinical Pharmacology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Endres
authors.affiliation: Department of Pathology, Ludwig-Maximilians-University, Munich, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Mayr
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018414:CD8-Positive T-Lymphocytes / Q000276:immunology* / Q000473:pathology; D005260:Female; D051858:Forkhead Transcription Factors; D006801:Humans; D007111:Immunity, Cellular; D008875:Middle Aged; D010051:Ovarian Neoplasms / Q000276:immunology* / Q000473:pathology; D012189:Retrospective Studies; D050378:T-Lymphocytes, Regulatory / Q000276:immunology* / Q000473:pathology
chemical_list: C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors