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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: OBJECTIVE, METHODS, RESULTS. Meshes: Adenocarcinoma, Adenocarcinoma of Lung, Adult, Aged, Aged, 80 and over, Biomarkers, Tumor, CD3 Complex, Female, Forkhead Transcription Factors, Humans, Immunohistochemistry, Kaplan-Meier Estimate, Lung Neoplasms, Lymphatic Metastasis, Lymphocytes, Tumor-Infiltrating, Male, Middle Aged, Multivariate Analysis, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Predictive Value of Tests, Receptors, Interleukin-12, Receptors, Interleukin-7, Risk Assessment, Risk Factors, Tissue Array Analysis.
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Are clinical impact of immune microenvironment in stage I lung adenocarcinoma : tumor interleukin-12 receptor β2 ( IL-12Rβ2 ) , IL-7R , and stromal FoxP3/CD3 ratio independent predictors of recurrence? Context: Mounting evidence suggests that tumor-infiltrating immune cells have prognostic value for patients with solid organ malignancies. Our aim was to investigate the prognostic significance of the immune microenvironment in patients with stage I lung adenocarcinoma (ADC). Using tissue microarray and immunohistochemistry, we investigated eight types of tumor-infiltrating immune cells in the tumor nest and tumor-associated stroma as well as tumor expression of five cytokines in a uniform cohort of 956 patients with stage I lung ADC (478 each in training and validation cohorts). Although a high density of stromal forkhead box P3 (FoxP3) -positive cells was associated with shorter recurrence-free probability (RFP; P = .043), the relative proportion of stromal FoxP3 to CD3 was a stronger predictor of recurrence (5-year RFP, 85% for high v 77% for low ratio; P = .004). High expression of tumor interleukin-12 receptor β2 (IL-12Rβ2) was associated with better outcome (5-year RFP, 90% for high v 80% for low expression; P = .026), whereas high expression of tumor IL-7R was associated with worse outcome (5-year RFP, 76% for high v 86% for low expression; P = .001). In multivariate analysis, these immune markers were independently associated with recurrence. Although IL-7R remained significant for poor overall survival, all the markers remained prognostic for recurrence in patients with stages IA and IB disease as well as for patients with tumors ≤ 2 cm.
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Our investigation confirms the biologic and prognostic significance of the tumor immune microenvironment for patients with stage I lung ADC and provides support for its use to stratify clinical outcome and immunotherapeutic interventions. Final Decision: yes