Clinical evaluation of tumour-infiltrating lymphocytes as a prognostic factor in patients with human papillomavirus-associated oropharyngeal squamous cell carcinoma

Komkrit Ruangritchankul, Ann Sandison, Fiona Warburton, Teresa Guerrero-Urbano, Miguel Reis Ferreira, Mary Lei, Selvam Thavaraj

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17 Citations (Scopus)
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Abstract

BACKGROUND: The majority of patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma (OpSCC) have favourable survival outcomes, but a significant minority of individuals will die of their disease. There are currently no definitive criteria to identify HPV-associated OpSCC patients with poor outcome. Recent reports suggest that quantitative evaluation of T-cell subpopulations in OpSCC may be of prognostic value, but the methods used have limited utility in a clinical diagnostic setting. We sought therefore to determine the clinical prognostic utility of tumour-infiltrating lymphocyte (TIL) evaluation in HPV-associated OpSCC within the context of a diagnostic histopathology setting.

METHODS: Representative diagnostic haematoxylin and eosin (H&E) stained slides from 232 consecutive HPV-associated OpSCC patients were classified as containing a high (TILHi ; diffuse, lymphocytes in >80% of tumour and stroma), moderate (TILMod ; patchy, present in 20-80% of tumour and stroma) or low (TILLo ; sparse or absent, present in <20% of tumour and stroma). Inter-observer reliability was assessed, and TILs category was then correlated with overall survival (OS) and disease-free survival (DFS).

RESULTS: Univariate and multivariate analysis showed a statistically significant difference in overall and disease-free survival estimates when TILHi and TILMod groups were compared with TILLo patients (p<0.0001 TILHi vs TILLo , p<0.0001 TILMod vs TILLo ). Statistical significance was retained when TILHi and TILMod were grouped into a single category (TILHi ) and compared to TILLo (p<0.0001).

CONCLUSION: We demonstrate the prognostic utility of TILs in HPV-associated OpSCC in clinical practice. A binary system classifying HPV-associated OpSCC into TILHi and TILLo on routine H&E staining stratifies patients into potentially favourable and unfavourable survival outcomes, respectively. This article is protected by copyright. All rights reserved.

Original languageEnglish
Pages (from-to)146-150
Number of pages5
JournalHistopathology
Volume75
Issue number1
Early online date30 May 2019
DOIs
Publication statusPublished - 1 Jul 2019

Keywords

  • human papillomavirus
  • oropharyngeal
  • tumour-infiltrating lymphocytes

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