Decreased CD8+ Lymphocytic Infiltration in Multifocal and Multicentric Glioblastomas
Run Wang, Yifu Song, Tianhao Hu, Xiaoliang Wang, Yang Jiang, Di Zhang, Juan‐Han Yu, Sheng Han, Liang Kan
Abstract
Purpose Multifocal and multicentric glioblastomas (mGBMs) are associated with a poorer prognosis compared to unifocal glioblastoma (uGBM). The presence of CD8 + tumor-infiltrating lymphocytes (TILs) is predictive of clinical outcomes in human malignancies. Here, we examined the CD8 + lymphocytic infiltration in mGBMs. Methods The clinical data of 57 consecutive IDH wildtype primary mGBM patients with histopathological diagnoses were retrospectively reviewed. CD8 + TILs were quantitatively evaluated by immunohistochemical staining. The survival function of CD8 + TILs was assessed by Kaplan–Meier analysis and Cox proportional hazard models. Results No significant difference in the concentration of CD8 + TILs was observed among foci from the same patient (P>0.150). The presence of CD8 + TILs was similar between multifocal and multicentric GBMs (P=0.885). The concentration of CD8 + TILs was significantly lower in mGBMs than in uGBMs (P=0.002). In mGBM patients, the CD8 + TIL level was associated with preoperative KPS (P=0.018). The median overall survival (OS) of the 57 mGBMs was 9 months. A low CD8 + TIL level (multivariate HR 4.404, 95% CI 1.954-9.926, P=0.0004) was an independent predictor of poor OS, while postoperative temozolomide chemotherapy (multivariate HR 6.076, 95% CI 2.330-15.842, P=0.0002) was independently associated with prolonged OS in mGBMs. Conclusions Decreased CD8 + TIL levels potentially correlate with unfavorable clinical outcome in mGBMs, suggesting an influence of the local immuno-microenvironment on the progression of mGBMs.