Article Text
Abstract
Introduction/Background High-grade serous cancer is often associated with ascites at presentation. Our objective was to quantify immune cells in the ascites before treatment and evaluate their impact on patient survival.
Methodology Forty-seven patients with primary disease and ascites were included in the study. Flow cytometry analysis was performed to detect percentages of CD3+ T cells (CD4+, CD8+, Tregs, and NKT cells), B cells, NK cells (CD56brightCD16- and CD56dimCD16+ subsets), macrophages, and dendritic cells. CD103 epithelial marker was further analyzed on T cells, and PD-1 and PD-L1 immune checkpoint molecules were analyzed on all immune cells. Cut-off of low and high percentages of immune cells was determined by the median of the variables, and the correlation with progression-free survival and overall survival was calculated.
Results CD3+ T cells were the predominant cells in the ascites (median 51%), while the presence of other immune cells was much lower (median ≤10%). PD-1 was mainly expressed on CD3+ T cells (median 20%), lower expression was observed on macrophages (median 10%), dendritic cells (median <10%), NK cells, and B cells (median <5%). PD-L1 expression was not detected. Progression-free survival and overall survival were significantly better in patients with high percentages of CD103+CD3+ T cells, PD-1+Tregs, CD56brightCD16- NK cells, and dendritic cells. High percentages of CD8+ T cells, macrophages, and PD-1+CD56brightCD16- NK cells, and low percentages of CD4+ also indicated significantly better overall survival.
Conclusion Our results highlight the potential of the ascites tumor immune microenvironment to provide novel prognostic markers for patients diagnosed with primary high-grade serous cancer.
Disclosures The authors made no disclosures. The study was funded by the research program P3–0289 of the Slovenian Research Agency.