New insights into the inflamed tumor immune microenvironment of gastric cancer with lymphoid stroma: from morphology and digital analysis to gene expression.


Journal

Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association
ISSN: 1436-3305
Titre abrégé: Gastric Cancer
Pays: Japan
ID NLM: 100886238

Informations de publication

Date de publication:
01 2019
Historique:
received: 16 04 2018
accepted: 09 05 2018
pubmed: 21 5 2018
medline: 16 4 2019
entrez: 21 5 2018
Statut: ppublish

Résumé

Gastric cancer with lymphoid stroma (GCLS) is characterized by prominent stromal infiltration of T-lymphocytes. The aim of this study was to investigate GCLS biology through analysis of clinicopathological features, EBV infection, microsatellite instability (MSI), immune gene-expression profiling and PD-L1 status in neoplastic cells and tumor immune microenvironment. Twenty-four GCLSs were analyzed by RNA in situ hybridization for EBV (EBER), PCR/fragment analysis for MSI, immunohistochemistry (PD-L1, cytokeratin, CD3, CD8), co-immunofluorescence (CK/PD-L1, CD68/PD-L1), NanoString gene-expression assay for immune-related genes and PD-L1 copy number alterations. CD3+ and CD8+ T-cell densities were calculated by digital analysis. Fifty-four non-GCLSs were used as control group. GCLSs displayed distinctive clinicopathological features, such as lower pTNM stage (p = 0.02) and better overall survival (p = 0.01). EBV+ or MSI-high phenotype was found in 66.7 and 16.7% cases, respectively. GCLSs harbored a cytotoxic T-cell-inflamed profile, particularly at the invasive front of tumors (p < 0.01) and in EBV+ cases (p = 0.01). EBV+ GCLSs, when compared to EBV- GCLSs, showed higher mRNA expression of genes related to Th1/cytotoxic and immunosuppressive biomarkers. PD-L1 protein expression, observed in neoplastic and immune stromal cells (33.3 and 91.7%, respectively), and PD-L1 amplification (18.8%) were restricted to EBV+/MSI-high tumors and correlated with high values of PD-L1 mRNA expression. This study shows that GCLS has a distinctive clinico-pathological and molecular profile. Furthermore, through an in-depth study of tumor immune microenvironment-by digital analysis and mRNA expression profiling-it highlights the role of EBV infection in promoting an inflamed tumor microenvironment, with putative therapeutic implications.

Sections du résumé

BACKGROUND
Gastric cancer with lymphoid stroma (GCLS) is characterized by prominent stromal infiltration of T-lymphocytes. The aim of this study was to investigate GCLS biology through analysis of clinicopathological features, EBV infection, microsatellite instability (MSI), immune gene-expression profiling and PD-L1 status in neoplastic cells and tumor immune microenvironment.
METHODS
Twenty-four GCLSs were analyzed by RNA in situ hybridization for EBV (EBER), PCR/fragment analysis for MSI, immunohistochemistry (PD-L1, cytokeratin, CD3, CD8), co-immunofluorescence (CK/PD-L1, CD68/PD-L1), NanoString gene-expression assay for immune-related genes and PD-L1 copy number alterations. CD3+ and CD8+ T-cell densities were calculated by digital analysis. Fifty-four non-GCLSs were used as control group.
RESULTS
GCLSs displayed distinctive clinicopathological features, such as lower pTNM stage (p = 0.02) and better overall survival (p = 0.01). EBV+ or MSI-high phenotype was found in 66.7 and 16.7% cases, respectively. GCLSs harbored a cytotoxic T-cell-inflamed profile, particularly at the invasive front of tumors (p < 0.01) and in EBV+ cases (p = 0.01). EBV+ GCLSs, when compared to EBV- GCLSs, showed higher mRNA expression of genes related to Th1/cytotoxic and immunosuppressive biomarkers. PD-L1 protein expression, observed in neoplastic and immune stromal cells (33.3 and 91.7%, respectively), and PD-L1 amplification (18.8%) were restricted to EBV+/MSI-high tumors and correlated with high values of PD-L1 mRNA expression.
CONCLUSIONS
This study shows that GCLS has a distinctive clinico-pathological and molecular profile. Furthermore, through an in-depth study of tumor immune microenvironment-by digital analysis and mRNA expression profiling-it highlights the role of EBV infection in promoting an inflamed tumor microenvironment, with putative therapeutic implications.

Identifiants

pubmed: 29779068
doi: 10.1007/s10120-018-0836-8
pii: 10.1007/s10120-018-0836-8
doi:

Substances chimiques

B7-H1 Antigen 0
CD274 protein, human 0

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

77-90

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Auteurs

Irene Gullo (I)

Department of Pathology, Centro Hospitalar de São João, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Patrícia Oliveira (P)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Maria Athelogou (M)

Definiens AG, Bernhard-Wicki Str 5, 80636, Munich, Germany.

Gilza Gonçalves (G)

Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
Department of Biomedical Sciences and Medicine, University of Algarve, Campus De Gambelas, 8005-139, Faro, Portugal.

Marta L Pinto (ML)

Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
INEB-Institute of Biomedical Engineering, University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
ICBAS-Institute of Biomedical Sciences Abel Salazar, University of Porto, Rua Jorge De Viterbo Ferreira 228, 4050-343, Porto, Portugal.

Joana Carvalho (J)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Ana Valente (A)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Hugo Pinheiro (H)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
Hospital Senhora da Oliveira, Rua Dos Cutileiros 114, 4835-044, Guimarães, Portugal.

Sara Andrade (S)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.
Department of Biomedicine, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.

Gabriela M Almeida (GM)

Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Ralf Huss (R)

Definiens AG, Bernhard-Wicki Str 5, 80636, Munich, Germany.

Kakoli Das (K)

Cancer and Stem Cell Biology Program, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.

Patrick Tan (P)

Cancer and Stem Cell Biology Program, Duke-NUS Medical School, 8 College Road, Singapore, 169857, Singapore.
Genome Institute of Singapore, Biopolis, 60 Biopolis St, Singapore, 138672, Singapore.
Cancer Science Institute of Singapore, National University of Singapore, 14 Medical Dr, Singapore, 117599, Singapore.

José C Machado (JC)

Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal.
Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal.

Carla Oliveira (C)

Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. carlaol@ipatimup.pt.
Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal. carlaol@ipatimup.pt.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal. carlaol@ipatimup.pt.

Fátima Carneiro (F)

Department of Pathology, Centro Hospitalar de São João, Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. fcarneiro@ipatimup.pt.
Department of Pathology, Faculty of Medicine of the University of Porto (FMUP), Al. Prof. Hernâni Monteiro, 4200-319, Porto, Portugal. fcarneiro@ipatimup.pt.
Institute of Molecular Pathology and Immunology at the University of Porto (Ipatimup), Rua Júlio Amaral de Carvalho 45, 4200-135, Porto, Portugal. fcarneiro@ipatimup.pt.
Instituto de Investigação e Inovação em Saúde (i3S), University of Porto, Rua Alfredo Allen 208, 4200-135, Porto, Portugal. fcarneiro@ipatimup.pt.

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