The predictive value of centre tumour CD8+ T cells in patients with hepatocellular carcinoma: comparison with Immunoscore

// Cheng Sun 1,2 , Jing Xu 3 , Jiaxi Song 1 , ChaoQun Liu 3 , Jinyu Wang 1 , Chenchun Weng 1 , Haoyu Sun 1 , Haiming Wei 1 , Weihua Xiao 1 , Rui Sun 1,2 and Zhigang Tian 1,2 1 Institute of Immunology and The CAS Key Laboratory of Innate Immunity and Chronic Disease, School of Life Sciences and Medical Center, University of Science & Technology of China, Hefei, Anhui, China 2 Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang, China 3 Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Guangzhou, China Correspondence to: Cheng Sun, email: // Zhigang Tian, email: // Keywords : CD8 + T cells, Immunoscore, HCC, prognostic indicator, TNM Received : June 30, 2015 Accepted : September 12, 2015 Published : September 22, 2015 Abstract The increasing evidences suggest that Immunoscore(IS), a combinatorial density analysis of CD8 + and CD3 + cells in the centre and invasive margin of tumour (CT and IM), has an advantage over the currently used tumour staging methods in a variety of tumours; however, IS in hepatocellular carcinoma remains unreported. In this study, IS was performed on serial sections from two HCC cohorts (total 449) and compared with current tumour staging systems. Kaplan–Meier curves illustrate a positive association between a higher IS (IS≥2) and longer survival of HCC patients. Although the IS was highly related to the outcome of patients, however, IS seems not to be the optimal prognostic factor when compared with the CD8 CT . As noted, among CD8 CT , CD8 IM , CD3 CT , CD3 IM and IS, CD8 CT, as an independent indicator, demonstrated the highest prognostic impact on both DFS and OS in our Cox multivariate regression analysis ( P < 0.0001). In our study, the minimum cut-off value was 93 CD8 CT cells per mm 2 , to be used to divide the patients into CD8 CT Hi group and CD8 CT Lo group in clinical settings. Our results suggest that CD8 CT densities analysis notably improved the accuracy of survival prediction with convenience of clinical manipulation in HCC.