Volume 29, Issue 5, 2020
DOI: 10.24205/03276716.2020.1105
To assess the significance and prognostic value of tumor-infiltrating lymphocytes before and after chemotherapy in head and neck squamous cell carcinoma patients
Abstract
Background: To the role of TILs in the head and neck squamous cell carcinoma (HNSCC) is at controversial level.
Objective: The retrospective study investigated effectiveness of a method for assessing TIL level and the relationship between TIL level and prognosis.
Materials and Methods: A database of patients with head and neck squamous cell carcinoma treated at the Department of Maxillofacial and Head and Neck Surgery from 1998 to 2017 was retrospectively reviewed. The total sample included 234 patients. The strict protocol was used to assess the TIL: determine tumor area, remove apoptotic cells and tissues, determine the type of cancer in the stromal region, quantify mononuclear cells to assess TILs, and evaluate TIL percentage in the stromal area.
Results: A Cox regression revealed that TIL could be an independent prognostic factor for DSS and DFS. Patients with very high TIL levels had a significantly lower recurrence rate compared to those with moderate (52.1% vs. 72%, P < 0.05) and low levels (52.1 vs. 81%, P < 0.05). Univariate analyses showed that TIL levels (HR ratio: 0.630, 95% CI: 0.476–0.911, p < 0.05) and nodal status (HR: 1.32, 95% CI: 1.32–1.98, p > 0.05) were positively related to DFS. Multivariate analyses further showed that TIL levels (HR: 0.884, 95% CI: 0.712–0.932, p > 0.05) and nodal status (HR: 1.452, 95% CI: 1.23–1.78, P > 0.05) could be used as independent predictors of DFS.
Conclusion: TIL levels are related to head and neck cancer prognosis and can be used to assess the likelihood of recurrence.
Keywords
Total leukocyte count, head and neck cancer, prognosis, chemotherapy