Immunocyte density in parathyroid carcinoma is correlated with disease relapse

J Endocrinol Invest. 2020 Oct;43(10):1453-1461. doi: 10.1007/s40618-020-01224-6. Epub 2020 Mar 26.

Abstract

Purpose: Parathyroid carcinoma (PC) is an endocrine malignancy with a poor prognosis. The tumour immune microenvironment is a critical factor influencing the outcomes of multiple cancer types. However, knowledge of the immune microenvironment in PC remains limited.

Methods: The intratumoural density of immunocytes and the Ki-67 index were evaluated immunohistochemically in 51 PC patient samples and were compared with clinicopathological features and parafibromin staining results. The Kaplan-Meier method and Cox proportional hazards analysis were used to estimate the effects of these variables on clinical outcomes.

Results: Intratumoural immunocyte density was not correlated with age, gender, urolithiasis, or palpation of a neck mass. The Ki-67 index was correlated with the intratumoural density of CD3+ cells (P = 0.022) and CD8+ cells (P = 0.021) and serum calcium levels (P = 0.022). In the intratumoural area of primary foci, Kaplan-Meier method showed that the risk factors associated with recurrence/metastasis were a low density of CD3+ (P = 0.017), CD8+ (P = 0.019) and CD45+ cells (P = 0.047), a high density of CD163+ cells (P = 0.003) and a high Ki-67 index (P = 0.004). Cox regression multivariate analysis revealed that CD163+ cell density (hazard ratio (HR) 16.19, 95% confidence interval (CI) 1.99-131.66; P = 0.009) and CD8+ cell density (HR 0.13, 95% CI 0.02-0.76, P = 0.024) were independent factors associated with PC relapse.

Conclusion: The immune microenvironment is an important factor influencing the relapse of PC. The intratumoural density of CD3+, CD8+, CD45+, and CD163+ immunocytes was correlated with disease-free survival (DFS) in patients with PC. Immunotherapy based on T lymphocytes or tumour-associated macrophages may be a promising treatment strategy.

Keywords: Parathyroid carcinoma; Relapse; T lymphocyte; Tumour-associated macrophage; Tumour-infiltrating immunocytes.

MeSH terms

  • Adult
  • Aged
  • Antigens, CD / analysis
  • Antigens, CD / metabolism
  • Antigens, Differentiation, Myelomonocytic / analysis
  • Antigens, Differentiation, Myelomonocytic / metabolism
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / metabolism
  • CD8-Positive T-Lymphocytes / pathology
  • Carcinoma / diagnosis*
  • Carcinoma / immunology
  • Carcinoma / metabolism
  • Carcinoma / mortality
  • Female
  • Humans
  • Immunohistochemistry
  • Lymphocyte Count
  • Lymphocytes, Tumor-Infiltrating / metabolism
  • Lymphocytes, Tumor-Infiltrating / pathology*
  • Male
  • Middle Aged
  • Neoplasm Metastasis
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / immunology
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Parathyroid Neoplasms / diagnosis*
  • Parathyroid Neoplasms / immunology
  • Parathyroid Neoplasms / metabolism
  • Parathyroid Neoplasms / mortality
  • Predictive Value of Tests
  • Prognosis
  • Receptors, Cell Surface / analysis
  • Receptors, Cell Surface / metabolism
  • Survival Analysis
  • Tumor Escape / physiology
  • Tumor Microenvironment / immunology
  • Young Adult

Substances

  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Biomarkers, Tumor
  • CD163 antigen
  • Receptors, Cell Surface