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Tumour Infiltrating Lymphocytes May Infer Good Prognoses in Some Cancer Patients: Presented at STS

By Ed Susman

FORT LAUDERDALE, FL -- February 4, 2008 -- By studying the levels of tumour-infiltrating lymphocytes in specimens of cancers, it might be possible to develop strong indicators of prognosis, researchers reported here at the Society of Thoracic Surgeons 44th Annual Meeting (STS).

"In this study we were just trying to make correlations between the tumour-infiltrating lymphocytes and cancers," said Enrico Ruffini, MD, Associate Professor of Thoracic Surgery, University of Torino, Torino, Italy, in an oral presentation on January 29.

Dr. Ruffini noted that some of the tumour-infiltrating lymphocytes (TILs) may fight the tumour, such as CD8-positive cells, while other cells such as CD4-positive cells may promote and restrict tumour growth.

"We are just starting to understand which of the TILs we can use against the tumour," he said. "These preliminary results may target further molecular analysis on TIL in lung neoplasms."

"TILs migrate inside and around the tumour -- some acting pro tumour growth and some against tumour growth. The relation between the host and the tumour cells is very complex," he noted.

Dr. Ruffini attempted to correlate pathological findings with information about the type of tumour and the relationship with host survival. He evaluated 1,290 specimens taken from more than 2,000 patients who had cancer surgery performed between 1993 and 2006. The specimens were examined and stained through conventional histology.

A specimen was deemed to be TIL positive if the pathologist could demonstrate there were at least 20 TILs in 10 high-powered fields examined, he explained.

"Overall prevalence was 22%," Dr. Ruffini said, with TIL counts significantly higher in non-small-cell adenocarcinoma and squamous lung cancers (24%) when compared with neuroendocrine tumours (5%)." He also saw correlations between higher concentrations of TILs and vascular invasion, tumour differentiation, and tumour diameter.

"The higher the stage of the cancer specimen, the lower the prevalence of TIL," he said, speculating that when the tumour is more advanced the immune response may be weaker. "I don't know if this is a cause and effect but this is an observation that has also been made in other reports."

"We found there was a survival advantage that reached significance in squamous cell carcinoma if there was a presence of TIL (P =.03), although in adenocarcinoma it was just a trend (P =.03). Dr. Ruffini said his studies indicate that TIL activity occurs not only in and around the tumour but also works to combat cancer spread.

"The study of TIL may be of help in providing prognostic information in addition to other parameters concerning tumour growth," he said.


[Presentation title: Tumour Infiltrating Lymphocytes (TIL): Prevalence, Correlations and Prognostic Significance in Lung Neoplasms. Abstract 45]

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