ART OF MEDICINE 2017
IMMUNE PROFILE OF HIGH – GRADE DIFFUSE ASTROCYTIC TUMORS AND ITS INFLUENCE ON TUMOR PROGRESSION
T.N. Chertenko, I.I. Yakovtsova
Abstract. Immunotherapeutic treatment has shown great efficiency in the therapy of different malignancies. The central nervous system (CNS) was considered an immunological privileged organ, but new data has changed this dogma. There is an evidence for permeability of the blood-brain barrier (BBB) for immune cells under conditions of tumor growth, such as in gliomas. Arming the immune system to mount a strong anti-tumor response in high grade gliomas is an aim of many research projects therefore investigation of immune profiles of gliomas is very important nowadays.
Objective. The study of expression of CD3, CD4, CD8 and CD68 markers in high-grade gliomas.
Methods. The research is based on histological and immunohistochemical investigation of 30 biopsies of patients with newly diagnosed high-grade gliomas in the period from 2011 to 2016. All biopsy samples were taken from Kharkiv regional clinical hospital and Kharkiv city clinical hospital №7. Immunoreactivity was defined as a proportion of a labeled cells in hot spot areas of tumor that calculated in 5 fields of view (x400): high (3), more than 30% of cells positive for given markers in hot spot areas, moderate (2), less than 30% of cells positive for given markers in hot spot areas, low (1), only single cells are positive for given markers in hot spot areas, negative reaction (0).
Results. We compared histological samples and clinical data of 15 patients with newly diagnosed high-grade gliomas, which relapsed during the 1-st year after surgery, and samples of 15 patients, who did not have relapse or death during the 1-st year after surgery. According to our data only high or middle expression of CD68 can be count as an independent marker of pour prognosis (Fisher’s exact test = 0,037, p <0,05). Independent expression of CD3, CD4 and CD8 markers did not show any prognostic value, but we found that solid tumors with immune profile CD3(2-3)/CD8(0-1) give statistically more relapses as other types of high grade gliomas (Fisher’s exact test = 0,04981, р < 0,05). In addition, we found a beneficial immune profile that was a marker of a better prognosis. It was СD3 (0-1)/CD4 (2-3)/ CD8 (2-3) profile (Fisher’s exact test Fisher’s exact test = 0,01869, р < 0,05).
Conclusions. The present data show that combination of СD3(0-1)/CD4(2-3)/CD8(2-3) is a predictor of better clinical outcome in high-grade glioma patients (Fisher’s exact test = 0,01869, р < 0,05), and combination of high or middle CD3 expression with low CD8 expression in solid high-grade gliomas is associated with higher rate of relapses during the 1-st year after surgery (Fisher’s exact test =0,04981, р < 0,05). CD68 high or middle expression can be used as an independent factor that tells about unfavorable prognosis for patients with malignant gliomas (Fisher’s exact test = 0,037, p <0,05).
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