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Open Access Research article

Prognostic impact of peritumoral lymphocyte infiltration in soft tissue sarcomas

Sveinung W Sorbye12*, Thomas K Kilvaer2, Andrej Valkov12, Tom Donnem34, Eivind Smeland5, Khalid Al-Shibli25, Roy M Bremnes34 and Lill-Tove Busund12

Author Affiliations

1 Dept of Clinical Pathology, University Hospital of North Norway, 9038 Tromso, Norway

2 Institute of Medical Biology, University of Tromso, Tromso, Norway

3 Dept of Oncology, University Hospital of North Norway, Tromso, Norway

4 Institute of Clinical Medicine, University of Tromso, Tromso, Norway

5 Dept of Pathology, Nordland Central Hospital, Bodo, Norway

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BMC Clinical Pathology 2012, 12:5  doi:10.1186/1472-6890-12-5

Published: 29 February 2012

Abstract

Background

The purpose of this study was to clarify the prognostic significance of peritumoral lymphocyte infiltration in the capsule of soft tissue sarcomas (STS). Multiple observations in preclinical and clinical studies have shown that the immune system has a role in controlling tumor growth and progression. Prognostic markers in potentially curable STS should guide therapy after surgical resection. The immune status at the time of resection may be important, but the prognostic significance of peritumoral lymphocytes is unknown.

Methods

Tissue microarrays from 80 patients with STS were constructed from duplicate cores of tissue from the tumor and the peritumoral capsule. Immunohistochemistry was used to evaluate the CD3+, CD4+, CD8+ and CD20+ lymphocytes in the tumor and the peritumoral capsule.

Results

In univariate analyses, increasing numbers of CD20+ (P = 0.032) peritumoral lymphocytes were associated with a reduced disease free survival (DSS). In multivariate analyses, a high number of CD20+ peritumoral lymphocytes (P = 0.030) in the capsule was an independent negative prognostic factor for DSS. There were no such associations of lymphocyte infiltration in the tumor.

Conclusions

A high density of CD20+ peritumoral lymphocytes is an independent negative prognostic indicator for patients with STS. Further research is needed to determine whether CD20 cells in the peritumoral capsule of STS may promote tumor invasion in the surrounding tissue and increase the metastatic potential.