Macrophage and mast-cell invasion of tumor cell islets confers a marked survival advantage in non-small-cell lung cancer

Welsh, Tomas J., Green, Ruth H., Richardson, Donna, Waller, David A., O'Byrne, Kenneth J., & Bradding, Peter (2005) Macrophage and mast-cell invasion of tumor cell islets confers a marked survival advantage in non-small-cell lung cancer. Journal of Clinical Oncology, 23(35), pp. 8959-8967.

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Abstract

Purpose The role played by the innate immune system in determining survival from non-small-cell lung cancer (NSCLC) is unclear. The aim of this study was to investigate the prognostic significance of macrophage and mast-cell infiltration in NSCLC.

Methods We used immunohistochemistry to identify tryptase+ mast cells and CD68+ macrophages in the tumor stroma and tumor islets in 175 patients with surgically resected NSCLC.

Results Macrophages were detected in both the tumor stroma and islets in all patients. Mast cells were detected in the stroma and islets in 99.4% and 68.5% of patients, respectively. Using multivariate Cox proportional hazards analysis, increasing tumor islet macrophage density (P < .001) and tumor islet/stromal macrophage ratio (P < .001) emerged as favorable independent prognostic indicators. In contrast, increasing stromal macrophage density was an independent predictor of reduced survival (P = .001). The presence of tumor islet mast cells (P = .018) and increasing islet/stromal mast-cell ratio (P = .032) were also favorable independent prognostic indicators. Macrophage islet density showed the strongest effect: 5-year survival was 52.9% in patients with an islet macrophage density greater than the median versus 7.7% when less than the median (P < .0001). In the same groups, respectively, median survival was 2,244 versus 334 days (P < .0001). Patients with a high islet macrophage density but incomplete resection survived markedly longer than patients with a low islet macrophage density but complete resection.

Conclusion The tumor islet CD68+ macrophage density is a powerful independent predictor of survival from surgically resected NSCLC. The biologic explanation for this and its implications for the use of adjunctive treatment requires further study. © 2005 by American Society of Clinical Oncology.

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ID Code: 65782
Item Type: Journal Article
Refereed: Yes
Additional URLs:
Keywords: article, cancer survival, cell invasion, controlled study, human, immunohistochemistry, innate immunity, lung non small cell cancer, macrophage, major clinical study, mast cell, priority journal, prognosis, proportional hazards model, stroma, adult, aged, chi square distribution, female, lung tumor, male, middle aged, pathology, survival, Aged, 80 and over, Carcinoma, Non-Small-Cell Lung, Chi-Square Distribution, Humans, Lung Neoplasms, Macrophages, Mast Cells, Proportional Hazards Models, Survival Analysis
DOI: 10.1200/JCO.2005.01.4910
ISSN: 0732-183X
Divisions: Current > Schools > School of Biomedical Sciences
Current > QUT Faculties and Divisions > Faculty of Health
Current > Institutes > Institute of Health and Biomedical Innovation
Copyright Owner: Copyright 2005 American Society of Clinical Oncology
Deposited On: 08 Jan 2014 04:12
Last Modified: 16 Apr 2015 06:05

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