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Prognostic signifi cance of tumor infi ltrating lymphocytes in gynecologic cancers

Jacek J. Sznurkowski

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2012, 10 (2), p. 150-156
Streszczenie

An interesting field of research in tumor immunology are T-lymphocytes and NK-cells in the area directly adjacent to tumor, i.e. tumor-infiltrating lymphocytes (TIL). An important indicator of immune control of cancer cells is the correlation between intensity of TIL infiltrate and clinical course of the disease. The aim of this paper is a review of particular types of immunocompetent cell infiltrating the tumor and a review of English literature as to data concerning prognostic significance of TIL subpopulations in ovarian, endometrial, cervical and vulvar cancer. Material and method: The PubMed database was searched using key words: CD8+, CD4+, FOXP3+, CD57+, CD56+, NK, combined with phrases: cervical cancer, vulvar cancer, ovarian cancer, endometrial cancer and prognosis. Results: Most important TILs include cytotoxic T-lymphocytes, mostly represented by the CD8+ population, helper T-lymphocytes, designed as CD4+ cells, regulatory lymphocytes Treg, where the most specific maker is transcription regulator forkhead box P3 (FOXP3), and NK/NKT cells (natural killer/natural killer T-lymphocytes), identified by CD56 and CD57. A close correlation was found between patients’ survival and intensity of infiltrate by CD8+ cells and indicators CD8+/FOXP3+, CD8+/CD4+ and ovarian cancer, endometrial cancer and cervical cancer. An exception to this is vulvar cancer, where CD8+, CD4+ and FOXP3+ have no prognostic significance. Conclusions: Severity of local cytolysis of tumors and inhibition of immunosuppressive activity of regulator cells may be used in future therapeutic strategies in patients with ovarian, endometrial and cervical cancer. In vulvar cancer we should rather focus on non-specific immune response for tumor control.

Słowa kluczowe
CD8+, CD4+, NK, TIL, ovarian cancer, endometrial cancer, cervical cancer, vulvar cancer, prognosis