Macrophage and mast-cell invasion of tumor cell islets confers a marked survival advantage in non-small-cell lung cancer

Tomas J Welsh, Ruth H Green, Donna Richardson, David A Waller, Kenneth J O'Byrne, Peter Bradding

Research output: Contribution to journalArticle (Academic Journal)peer-review

Abstract

PURPOSE: The role played by the innate immune system in determining survival from non-small-cell lung cancer (NSCLC) is unclear. The aim of this study was to investigate the prognostic significance of macrophage and mast-cell infiltration in NSCLC.

METHODS: We used immunohistochemistry to identify tryptase+ mast cells and CD68+ macrophages in the tumor stroma and tumor islets in 175 patients with surgically resected NSCLC.

RESULTS: 5-year survival was 52.9% in patients with an islet macrophage density greater than the median versus 7.7% when less than the median (P < .0001). In the same groups, respectively, median survival was 2,244 versus 334 days (P < .0001). Patients with a high islet macrophage density but incomplete resection survived markedly longer than patients with a low islet macrophage density but complete resection.

CONCLUSION: The tumor islet CD68+ macrophage density is a powerful independent predictor of survival from surgically resected NSCLC. The biologic explanation for this and its implications for the use of adjunctive treatment requires further study.

Original languageEnglish
Pages (from-to)8959-67
Number of pages9
JournalJournal of Clinical Oncology
Volume23
Issue number35
DOIs
Publication statusPublished - 10 Dec 2005

Keywords

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma, Non-Small-Cell Lung/pathology
  • Chi-Square Distribution
  • Female
  • Humans
  • Immunohistochemistry
  • Lung Neoplasms/pathology
  • Macrophages/pathology
  • Male
  • Mast Cells/pathology
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Survival Analysis

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