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  • Role of Immune Microenviron...
    De Simoni, Ottavia; Dal Santo, Luca; Scarpa, Marco; Munari, Giada; Spolverato, Ylenia Camilla; Scapinello, Antonio; Lonardi, Sara; Soldà, Caterina; Bergamo, Francesca; Fantin, Alberto; Bardini, Romeo; Pilati, Pierluigi; Fassan, Matteo; Gruppo, Mario

    Current oncology, 06/2023, Letnik: 30, Številka: 6
    Journal Article

    Pancreatic ductal adenocarcinoma (PDAC) is characterized by a highly immunosuppressive tumor microenvironment (TME). The aim of this study is to determine the potential significant TME immune markers of long-term survival. We retrospectively included patients with a diagnosis of resectable PDAC having undergone upfront surgery. Immunohistochemical (IHC) staining using tissue microarray for PD-L1, CD3, CD4, CD8, FOXP3, CD20, iNOS and CD163 was performed in order to characterize the TME. The primary endpoint was long-term survival, defined as the Overall Survival > 24 months from surgery. A total of 38 consecutive patients were included, and 14 (36%) of them were long-term survivors. Long-term survivors showed a higher density of CD8+ lymphocytes intra- and peri-acinar ( = 0.08), and a higher CD8/FOXP3 intra- and peri-tumoral ratio ( = 0.05). A low density of intra- and peri-tumoral FOXP3 infiltration is a good predictor of long-term survival ( = 0.04). A significant association of the low density of intra- and peri-tumoral tumor-associated macrophages (TAMs) iNOS+ with long-term survival was detected ( = 0.04). Despite the retrospective nature and small sample size, our study showed that the high infiltration of CD8+ lymphocytes and low infiltration of FOXP3+ and TAMs iNOS+ are predictors of good prognosis. A preoperative assessment of these potential immune markers could be useful and determinant in the staging process and in PDAC management.