title: Tumor infiltrating lymphocytes and survival in patients with head and neck squamous cell carcinoma.
abstract: Because immune responses within the tumor microenvironment are important predictors of tumor biology, correlations of types of tumor infiltrating lymphocytes (TILs) with clinical outcomes were determined in 278 patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  
  Infiltrating levels of CD4 (helper T cells), CD8 (cytotoxic/suppressor T cells), FoxP3 (regulatory T cells), CD68 (myeloid-derived suppressor cells,) and CD1a (Langerhans) cells were measured in tissue microarrays (TMAs). Cox models tested associations with patient outcomes after adjusting for all known prognostic factors. Median follow-up was 36.6 months.
  
  
  
  Higher CD4 and CD8 TIL levels were associated with improved overall survival (OS; hazard ratio [HR] = 0.77; 95% confidence interval [CI]  = 0.65-0.93; p = .005 and HR = 0.77; 95% CI = 0.64-0.94; p = .008, respectively), and relapse-free survival (RFS; p = .03 and .05, respectively). After controlling for prognostic factors, higher CD4 levels predicted improved OS and disease-specific survival (DSS; p = .003 and p = .004, respectively).
  
  
  
  The findings suggest that TILs are a significant independent prognostic factor for HNSCC that differ by treatment. © 2016 Wiley Periodicals, Inc. Head Neck 38: 1074-1084, 2016.
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Nghia
authors.initials: N
authors.lastname: Nguyen
authors.affiliation: Center for Cancer Biostatistics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Emily
authors.initials: E
authors.lastname: Bellile
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Daffyd
authors.initials: D
authors.lastname: Thomas
authors.affiliation: Department of Pathology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Jonathan
authors.initials: J
authors.lastname: McHugh
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Laura
authors.initials: L
authors.lastname: Rozek
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Shama
authors.initials: S
authors.lastname: Virani
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Lisa
authors.initials: L
authors.lastname: Peterson
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Thomas E
authors.initials: TE
authors.lastname: Carey
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Heather
authors.initials: H
authors.lastname: Walline
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Jeffery
authors.initials: J
authors.lastname: Moyer
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Matthew
authors.initials: M
authors.lastname: Spector
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan.
authors.forename: Daniel
authors.initials: D
authors.lastname: Perim
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Mark
authors.initials: M
authors.lastname: Prince
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Scott
authors.initials: S
authors.lastname: McLean
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Carol R
authors.initials: CR
authors.lastname: Bradford
authors.affiliation: Center for Cancer Biostatistics, Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
authors.forename: Jeremy M G
authors.initials: JM
authors.lastname: Taylor
authors.affiliation: Department of Otolaryngology, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Wolf
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000276:immunology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000276:immunology* / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D000077195:Squamous Cell Carcinoma of Head and Neck; D016019:Survival Analysis; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: cancer; prognosis; tumor infiltrating lymphocytes