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Prognostic Impact of the Immunoscore Based on Whole-Slide Image Analysis of CD3+Tumor-Infiltrating Lymphocytes in Diffuse Large B-Cell Lymphoma

Cited 2 time in Web of Science Cited 2 time in Scopus
Authors

Han, Bogyeong; Yim, Jeemin; Lim, Sojung; Na, Sei; Lee, Cheol; Kim, Tae Min; Paik, Jin-Ho; Kim, Sehui; Jeon, Yoon Kyung

Issue Date
2023-09
Publisher
Nature Publishing Group
Citation
Modern Pathology, Vol.36 No.9, p. 100224
Abstract
An Immunoscore based on tumor-infiltrating T-cell density was validated as a prognostic factor in patients with solid tumors. However, the potential utility of the Immunoscore in predicting the prognosis of patients with diffuse large B-cell lymphoma (DLBCL) is unclear. Here, the prognostic value of an Immunoscore based on tumor-infiltrating CD3+ T-cell density was evaluated in 104 patients with DLBCL who underwent R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone) therapy. Digitally scanned whole-slide images were analyzed using Aperio ImageScope software. CD3+ cell densities in the whole tumor area were quantitated using 3 different methods, including number of CD3+ cells/area (mm2), ratio of CD3+ cells to total cells, and ratio of CD3+ cells to CD20+ cells. There was a high concordance among the 3 methods. Patients with low CD3+ cell density had an elevated serum lactate dehydrogenase level and a high Ki-67 proliferation index (all, P < .05). Patients with low CD3+ cell density, according to all 3 methods, had worse overall survival (OS) and worse progression-free survival (P < .05, all). They also had poor OS, independent of MYC/BCL2 double expression (DE) status, Eastern Cooperative Oncology Group performance status, or Ann Arbor stage (all, P < .05). These results were validated using 2 publicly available data sets. In both validation cohorts, patients with low CD3E mRNA expression had an elevated serum lactate dehydrogenase level, extranodal site involvement, and DE status (P < .05). They also had worse progression-free survival (P =.067 and P =.002, respectively) and OS (both P < .05). A low CD3E mRNA level was predictive of poor OS, independent of DE status. An Immunoscore based on whole-slide image analysis of CD3+ T-cell infiltration was sufficient to predict survival in patients with DLBCL. Low CD3+ cell density was a poor prognostic factor, independent of other prognostic parameters and DE status.& COPY; 2023 United States & Canadian Academy of Pathology. Published by Elsevier Inc. All rights reserved.
ISSN
0893-3952
URI
https://hdl.handle.net/10371/195833
DOI
https://doi.org/10.1016/j.modpat.2023.100224
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  • College of Medicine
  • Department of Medicine
Research Area Head and Neck Pathology, Hematopathology, Renal Pathology

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