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dc.contributor.authorPaulsen, Erna-Elise
dc.contributor.authorAndersen, Sigve
dc.contributor.authorRakaee, Mehrdad
dc.contributor.authorBremnes, Roy M.
dc.contributor.authorRasmussen Busund, Lill-Tove
dc.contributor.authorDønnem, Tom
dc.date.accessioned2021-01-25T10:28:03Z
dc.date.available2021-01-25T10:28:03Z
dc.date.issued2020-10-09
dc.description.abstractThe TNM classification is well established as a state-of-the-art prognostic and treatment-decision-making tool for non-small cell lung cancer (NSCLC) patients. However, incorporation of biological data may hone the TNM system. This article focuses on choosing and incorporating subsets of tissue-infiltrating lymphocyte (TIL), detected by specific immunohistochemistry and automatically quantified by open source software, into a TNM-Immune cell score (TNM-I) for NSCLC. We use common markers (CD3, CD4, CD8, CD20 and CD45RO) of TILs to identify TIL subsets in tissue micro-arrays comprising tumor tissue from 553 patients resected for primary NSCLC. The number of TILs is automatically quantified using open source software (QuPath). Their prognostic efficacy, alone and within a TNM-I model, is evaluated in all patients and histological subgroups. Compared with previous manual semi-quantitative scoring of TILs in the same cohort, the present digital quantification proved superior. As a proof-of-concept, we construct a TNM-I, using TNM categories and the CD8+ TIL density. The TNM-I is an independent prognosticator of favorable diagnosis in both the overall cohort and in the main histological subgroups. In conclusion, CD8+ TIL density is the most promising candidate marker for a TNM-I in NSCLC. The prognostic efficacy of the CD8+ TIL density is strongest in lung squamous cell carcinomas, whereas both CD8+ TILs and CD20+ TILs, or a combination of these, may be candidates for a TNM-I in lung adenocarcinoma. Furthermore, based on the presented results, digital quantification is the preferred method for scoring TILs in the future.en_US
dc.identifier.citationPaulsen, Andersen, Rakaee, Bremnes, Rasmussen Busund, Dønnem. Digitally quantified CD8+ cells: the best candidate marker for an immune cell score in non-small cell lung cancer?. Carcinogenesis. 2020en_US
dc.identifier.cristinIDFRIDAID 1861309
dc.identifier.doi10.1093/carcin/bgaa105
dc.identifier.issn0143-3334
dc.identifier.issn1460-2180
dc.identifier.urihttps://hdl.handle.net/10037/20461
dc.language.isoengen_US
dc.publisherOxford University Pressen_US
dc.relation.journalCarcinogenesis
dc.relation.projectIDHelse Nord RHF: HNF1521-20en_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2020 The Author(s)en_US
dc.subjectVDP::Medical disciplines: 700::Basic medical, dental and veterinary science disciplines: 710en_US
dc.subjectVDP::Medisinske Fag: 700::Basale medisinske, odontologiske og veterinærmedisinske fag: 710en_US
dc.titleDigitally quantified CD8+ cells: the best candidate marker for an immune cell score in non-small cell lung cancer?en_US
dc.type.versionpublishedVersionen_US
dc.typeJournal articleen_US
dc.typeTidsskriftartikkelen_US
dc.typePeer revieweden_US


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