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Anthony Blahnik



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    P2.04 - Immunooncology (Not CME Accredited Session) (ID 953)

    • Event: WCLC 2018
    • Type: Poster Viewing in the Exhibit Hall
    • Track:
    • Presentations: 1
    • Moderators:
    • Coordinates: 9/25/2018, 16:45 - 18:00, Exhibit Hall
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      P2.04-06 - Increased Plasma Cell % and Decreased B-Cells in Tumor Immune Infiltrates Are Associated with Worse Prognosis in Lung Adenocarcinomas (ID 12303)

      16:45 - 18:00  |  Author(s): Anthony Blahnik

      • Abstract
      • Slides

      Background

      Clinical significance of tumor-infiltrating plasma cells and B-cells in lung adenocarcinoma is not well known.

      a9ded1e5ce5d75814730bb4caaf49419 Method

      CD3, CD20 and MUM1 immunostains were performed on representative tumor blocks selected from 120 consecutive lung adenocarcinoma cases resected. CD3-positive T-cells, CD20-positive B-cells, and MUM1-positive plasma cells were separately enumerated in the intraepithelial (IE) compartment and the stroma (ST) by digital image analyses. Distribution of measured tumor-infiltrating cells was systematically evaluated and their associations with patient’s overall survival (OS) modeled using Cox proportional hazards analysis.

      4c3880bb027f159e801041b1021e88e8 Result

      Median age of patients was 69 years (range, 46-91 years) and 52 patients were male. Eighty-two, 17, and 21 patients were tumor stage I, II, and III/IV, respectively. Ninety patients had surgery only; 30 had surgery with adjuvant chemotherapy and/or radiation therapy. Median numbers (interquartile range) of CD20-positive B-cells per 1mm2 in the tumor area (IE plus ST) and in IE compartment were 590 (224-1276) and 101 (38-109), respectively; the corresponding numbers of MUM1-positive plasma cells were 298 (180-605), and 67 (22-145), respectively. The percent of MUM1-positive plasma cells among all tumor immune infiltrate (i.e. MUM1-positive cells/[CD3-positive cells + CD20-positive cells + MUM1- positive cells] x 100) ranged from 0 to 60% (median 10%) in the tumor area and showed a significant association with OS by univariate Cox analysis (continuous variable; negative correlation with HR=12.50 [95% confidence interval [CI], 1.75-89.27]). There was a significant association between IE CD20-positive B-cells and the patient’s OS in univariate analysis (continuous variable; positive correlation with hazard ratio [HR]=0.81 (95% CI, 0.68-0.96). Both parameters remained significant by multivariate analysis. Cut-off points (low vs high) showing significant associations with patient’s OS were found by log-rank test (Table 1).

      Table 1. Summary of Cox proportional hazards analysis for overall survival

      CD20 cells, intraepithelial

      MUM1/(CD3+CD20+MUM1),

      intraepithelial and stromal

      Cut-offs (number)

      HR (95% CI)

      p

      Cut-offs

      (%)

      HR (95% CI)

      p

      >72.13

      0.63(0.37-0.04)

      0.070

      >20.4%

      1.65(0.98-2.79)

      0.063

      <72.13

      --

      <20.4%

      >75.49

      0.59(0.36-0.99)

      0.045

      >21.1%

      1.71(1.01-2.90)

      0.047

      <75.49

      --

      <21.1%

      --

      >85.66

      0.49 (0.29,0.83)

      0.007

      >24.79%

      2.29 (1.33,3.94)

      0.003

      <85.66

      --

      <24.79%

      --

      >101.55

      0.57(0.34,0.96)

      0.034

      >26.0%

      2.00(1.07-3.75)

      0.031

      <101.55

      --

      <26.0%

      --

      >101.80

      0.65(0.39,1.09)

      0.105

      >26.4%

      1.83(0.97-3.45)

      0.064

      <101.80

      --

      <26.4%

      --

      8eea62084ca7e541d918e823422bd82e Conclusion

      High plasma cell % among immune infiltrate in the tumor area and low IE B-cell count were associated with worse prognosis in lung adenocarcinoma patients.

      6f8b794f3246b0c1e1780bb4d4d5dc53

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