Abstract : INTRODUCTION Tumor-infiltrating lymphocytes (TILs) and forkhead box transcription factor positive (
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Abstract : INTRODUCTION Tumor-infiltrating lymphocytes (TILs) and forkhead box transcription factor positive (FoxP3(+)) regulatory T-lymphocytes (TREGs) have been analyzed in a variety of tumors but not in oesophageal adenocarcinoma.|PATIENTS AND METHODS Tissue from 130 adenocarcinomas of the oesophagus was re-evaluated in the centre and periphery of tumour respectively using immunohistochemical staining with anti-CD3 anti-CD4 anti-CD8 anti-CD25 and anti-FoxP3 antibodies. Patients were stratified according neoadjuvant treatment. 106 patients proceeded directly to surgery and 24 underwent pre-operative radio-chemotherapy (RCT).|RESULTS In patients without RCT TILs were found significantly more frequently in the periphery with the exception of CD25(+) cells. Patients with centrally low counts of FoxP3(+) TREGs had higher tumour stages than patients with high counts (p lt 0.011). The number of FoxP3(+) TREGs was significantly associated with the number of CD8(+) cells (centre p lt 0.001 periphery p = 0.002). The multivariate regression analysis identified UICC stage (IIB/III vs. I/IIA hazard ratio 2.6 p = 0.011) and completeness of resection (no vs. yes hazard ratio 2.3 p = 0.015) as independent predictors of survival. RCT significantly reduced the number of TREGs in the centre (p = 0.016) but not the number of the other TILs.|CONCLUSION: UICC stage and completeness of resection but none of the TILs were prognostic markers for long-term survival. We found no morphologic evidence that TREGs suppress immunological response, represented by the infiltration of CD8(+) cells. Preoperative RCT affected the centre of tumours more than the periphery, which may indicate that it does not inhibit the host-to-tumour reaction. RCT affects TREGs more than the other TILs.|
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