Prognostic Value of Dickkopf-1 and ß-catenin Expression According to the Antitumor Immunity of CD8-Positive Tumor-Infiltrating Lymphocytes in Biliary Tract Cancer
Seoree KimHye Sung WonJi Hyun YangDer Sheng SunKwangil YimSoon Auck HongJung‐Sook YoonSang Hoon ChunKee‐Hwan KimYoon Ho Ko
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Abstract The role of β-catenin and Dickkopf-1 (DKK1) is dependent on the specific immunobiology of T cell inflammation in biliary tract cancer (BTC). We aimed to analyze the role of DKK1 or β-catenin as a prognostic factor in BTC, and determine the clinical associations of ß-catenin and DKK1 with CD8 + tumor-infiltrating lymphocytes (TIL). We used data from The Cancer Genome Atlas Research Network and the clinicopathological data of 145 patients with BTC who had undergone primary radical resection between 2006 and 2016. CD8 + TIL expression was a significant predictor of favorable overall survival (OS) and relapse-free survival (RFS) (median OS, 34.9 months in high-TIL, 16.7 months in low-TIL, P < 0.0001 respectively; median RFS, 27.1 months in high-TIL, 10.0 months in low-TIL, P < 0.0001 respectively). In the high-CD8 + TIL BTC group, the tumor expression of β-catenin and DKK1 had a significant negative impact on either OS or RFS. In the low-TIL BTC group, there were no differences according to ß-catenin and DKK1 expression. Cox regression multivariate analysis demonstrated that CD8 + TIL and β-catenin retained significant association with OS. Among patients with resected BTC, the β-catenin and DKK1 protein and high CD8 + TIL levels were associated with poor and good clinical outcomes, respectively.Keywords:
DKK1
Tumor-infiltrating lymphocytes
Thyroid hormones are key regulators of bone homeostasis, and Wnt signaling has been implicated in thyroid hormone-associated bone loss. Here we tested whether hyperthyroidism and hypothyroidism interfere with dickkopf-1 (DKK1) and sclerostin, two inhibitors of Wnt signaling. Twelve-week-old male C57BL/6 mice were rendered either hyperthyroid or hypothyroid. Hyperthyroid mice displayed decreased trabecular (-54%, P < .001) and cortical bone density (-5%, P < .05) and reduced cortical thickness (-15%, P < .001), whereas hypothyroid mice showed a higher trabecular bone density (+26%, P < .001) with unchanged cortical bone parameters. Histomorphometry and biochemical markers of bone remodeling indicated high bone turnover in hyperthyroid mice and low bone turnover in hypothyroid mice. In vivo, serum DKK1 concentrations were decreased in hyperthyroid mice (-24%, P < .001) and increased in hypothyroid mice (+18%, P < .01). The increase of the number of DKK1-positive cells in hypothyroid mice was confirmed at the tissue level. Interestingly, sclerostin was increased in both disease models, although to a higher extent in hyperthyroid mice (+50%, P < .001, and +24%, P < .05). Serum sclerostin concentrations adjusted for bone mass were increased by 3.3-fold in hyperthyroid (P < .001) but not in hypothyroid mice. Consistently, sclerostin mRNA expression and the number of sclerostin-positive cells were increased in hyperthyroid but not in hypothyroid mice. Our data show that thyroid hormone-induced changes in bone remodeling are associated with a divergent regulation of DKK1 and sclerostin. Thus, the modulation of Wnt signaling by thyroid hormones may contribute to thyroid hormone-associated bone disease and altered expression of Wnt inhibitors may emerge as potential therapeutic targets.
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DKK1
Bone remodeling
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The American Joint Committee on Cancer (AJCC) staging system is inadequate for an accurate prognosis in nasopharyngeal carcinoma (NPC). Thus, new biomarkers are under intense investigation. Here, we investigated whether the density of TILs could predict prognosis in NPC. First, we used 1490 cases of nasopharyngeal carcinoma samples from two independent cohorts to evaluate the density and distribution of tumor‐infiltrating lymphocytes (TILs). Second, in one cohort, we assessed associations between TILs and clinical outcomes in 593 randomly selected samples (defined as the training set) and validated findings in the remaining 593 samples (defined as the validation set). Furthermore, we confirmed the prognostic value of TILs in a second independent cohort of 304 cases (defined as the independent set). Based on multivariable Cox regression analysis, we also established an effective prognostic nomogram including TILs to improve accuracy in predicting disease‐free survival (DFS) for patients with nondisseminated NPC. We found that high TILs in the training set were significantly associated with favorable DFS [hazard ratio (HR) 0.41, 95% confidence interval (CI) 0.28–0.58, p < 0.001], overall survival (OS, HR 0.42, 95% CI 0.27–0.64, p < 0.001), distant metastasis‐free survival (DMFS, HR 0.37, 95% CI 0.23–0.58, p < 0.001) and local‐regional recurrent free survival (LRRFS, HR 0.43, 95% CI 0.25–0.73, p = 0.002). Multivariate analysis showed that TILs are an independent prognostic indicator for DFS in all cohorts. In summary, this study indicated that TILs may reflect the immunological heterogeneity of NPC and could represent a new prognostic biomarker.
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Abstract The role of β-catenin and Dickkopf-1 (DKK1) is dependent on the specific immunobiology of T cell inflammation in biliary tract cancer (BTC). We aimed to analyze the role of DKK1 or β-catenin as a prognostic factor in BTC, and determine the clinical associations of ß-catenin and DKK1 with CD8 + tumor-infiltrating lymphocytes (TIL). We used data from The Cancer Genome Atlas Research Network and the clinicopathological data of 145 patients with BTC who had undergone primary radical resection between 2006 and 2016. CD8 + TIL expression was a significant predictor of favorable overall survival (OS) and relapse-free survival (RFS) (median OS, 34.9 months in high-TIL, 16.7 months in low-TIL, P < 0.0001 respectively; median RFS, 27.1 months in high-TIL, 10.0 months in low-TIL, P < 0.0001 respectively). In the high-CD8 + TIL BTC group, the tumor expression of β-catenin and DKK1 had a significant negative impact on either OS or RFS. In the low-TIL BTC group, there were no differences according to ß-catenin and DKK1 expression. Cox regression multivariate analysis demonstrated that CD8 + TIL and β-catenin retained significant association with OS. Among patients with resected BTC, the β-catenin and DKK1 protein and high CD8 + TIL levels were associated with poor and good clinical outcomes, respectively.
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Abstract Recent studies have shown that CD73 could be a new promising target in breast cancer (BC). CD73 is a cell surface ecto-nucleotidase, expressed by both tumor cells and immune cells, that catalyses the hydrolysis of AMP into adenosine in the tumor microenvironment. Adenosine has immunosuppressive and tumor-promoting effects and is therefore implicated in the mechanism of tumor immune escape. High CD73 gene expression has recently been associated with a poor prognosis in triple negative BC. While tumor expression of CD73 is well documented, expression of CD73 on tumor-infiltrating immune cells remains poorly characterized. We evaluated the expression of CD73 on immune cells present in fresh tissue homogenates (GentleMACS with no enzymatic digestion) from untreated primary breast tumors and compared to its expression to peripheral blood mononuclear cells (PBMC) from patients with breast cancer. In the peripheral blood, CD73 was found mostly expressed on CD4+ (mean percentage: 13.24±12.88%) and CD8+T cells (mean percentage: 40.78±19.42%) and a major subset of B cells (mean percentage: 51.93±21.83%). Analysis of fresh tumor tissues revealed that less than 25% of CD45+ tumor immune infiltrates express CD73 (mean percentage: 17.63± 5,1%) and was relatively similar to its expression on PBMC (mean percentage: 14.87± 9.5%). In the tumor immune infiltrates, B cells were the immune subset with the higher proportion of CD73+ cells (mean percentage: 53.27±14.63%) while the proportion of CD73+ was lower on tumor-infiltrating CD8+ T cells compared to CD8+ PBMC (p value: 0.022). Notably, we observed that CD73 expression was significantly higher on tumor-infiltrating NK cells and CD14+ myeloid cells compared to peripheral cells (p = 0.005 for NK cells, and p = 0.015 for CD14+ cells). Immunofluorescence analysis confirmed that CD73 is expressed by both tumor cells, CD45+ immune cells and stromal cells in breast cancer. These results suggest that CD73 is differentially expressed on tumor-infiltrating leukocytes compared to PBMCs. Modulation of CD73 activity on tumor-infiltrating leukocytes may therefore contribute to the mechanism-of-action of anti-CD73 therapies. Citation Format: Laurence Buisseret, Soizic Garaud, Bertrand Allard, Isabelle Cousineau, Guillaume Chouinard, Christos Sotiriou, Karen Willard-Gallo, John Stagg. CD73 expression on tumor-infiltrating breast cancer leukocytes. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 3361. doi:10.1158/1538-7445.AM2015-3361
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The density of tumor-infiltrating lymphocytes has been reported to reflect the antitumor immune status, and many reports have shown that tumor-infiltrating CD8+ and total T-lymphocytes may be strong prognostic biomarkers in colorectal cancer. We previously reported that the density of tumor-infiltrating immune cells in hematoxylin and eosin (H&E)-stained sections may be an easily available prognostic biomarker. However, it remains unclear whether the density of tumor-infiltrating immune cells in H&E-stained sections accurately reflects the antitumor immune status.A total of 308 patients who underwent curative resection for stage II/III colorectal cancer were enrolled. The density of both tumor-infiltrating immune cells in H&E-stained sections and tumor-infiltrating lymphocyte subsets was assessed by immunohistochemistry.The density of tumor-infiltrating immune cells in H&E-stained sections was significantly and positively correlated with that of tumor-infiltrating CD4+/CD8+/total T-lymphocytes.The density of tumor-infiltrating immune cells in H&E-stained sections may be a reasonable immunological biomarker.
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Background: The role of tumor-infiltrating lymphocytes (TILs) in breast cancer has been extensively studied over the last decade; it now believed that they have predictive and prognostic roles in breast cancer. Materials and Method: We identified 70 patients with primary breast cancers receiving neoadjuvant chemotherapy (NAC); we analyzed pre-and post-treatment tumor-infiltrating immune cells (CD3, CD8) by immunohistochemistry. Immune cell profiles were analyzed and correlated with response and survival. Results: We identified two tumor-infiltrating immune cell profiles, which were able to predict pathological complete response (pCR) to NAC. A higher infiltration by CD8 and CD3 lymphocytes was associated with occurrence of pCR. Analysis of the immune infiltrate in post-chemotherapy treatment identified a profile of high CD8 and low CD3 infiltration associated with better disease free survival. Conclusions: Tumor lymphocytic infiltrates play a predictive role for detecting pCR and a prognostic role in detecting the outcome. Further understanding of the mechanisms underlying the distribution of immune cells and their changes after chemotherapy may contribute to the development of new immune-targeted therapies for breast cancer.
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Tumor-infiltrating lymphocytes
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Abstract The role of β-catenin and Dickkopf-1 (DKK1) is dependent on the specific immunobiology of T cell inflammation in biliary tract cancer (BTC). We aimed to analyze the role of DKK1 or β-catenin as a prognostic factor in BTC, and determine the clinical associations of ß-catenin and DKK1 with CD8+ tumor-infiltrating lymphocytes (TIL). We used data from The Cancer Genome Atlas Research Network and the clinicopathological data of 145 patients with BTC who had undergone primary radical resection between 2006 and 2016. CD8+ TIL expression was a significant predictor of favorable overall survival (OS) and relapse-free survival (RFS) (median OS, 34.9 months in high-TIL, 16.7 months in low-TIL, P < 0.0001 respectively; median RFS, 27.1 months in high-TIL, 10.0 months in low-TIL, P < 0.0001 respectively). In the high-CD8+ TIL BTC group, the tumor expression of β-catenin and DKK1 had a significant negative impact on either OS or RFS. In the low-TIL BTC group, there were no differences according to ß-catenin and DKK1 expression. Cox regression multivariate analysis demonstrated that CD8+ TIL and β-catenin retained significant association with OS. Among patients with resected BTC, the β-catenin and DKK1 protein and high CD8+ TIL levels were associated with poor and good clinical outcomes, respectively.
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