Background

The immune response to melanoma is manifested locally by tumor-infiltrating lymphocytes (TILs). Men and women are known to have varying patterns of immunity, yet sex-specific prognostic implications of TILs have not been explored.

Methods

Patients who had clinically localized primary melanoma with a Breslow thickness of 0.76 mm or more and underwent sentinel lymph node (SLN) biopsy at our institution were identified. The association between TILs (absent, nonbrisk, and brisk) and SLN positivity was evaluated by using logistic regression. Overall survival (OS) was evaluated by TIL status and sex.

Results

Among 1367 patients identified, 794 were men. TILs were brisk in 143 lesions, nonbrisk in 903, and absent in 321, which did not vary by sex (P = .71). SLN positivity was associated with TILs among men (brisk, 3.8%; nonbrisk, 16.9%; and absent, 26.6% [P < .001]). In contrast, there was no association between SLN positivity and TILs among women (P = .49). Interaction between brisk TILs and sex on SLN positivity was significant (P = .029). Among men, presence of brisk TILs was associated with prolonged OS (P = .038) but not after adjustment for SLN status (P = .42). There was no association between TIL status and OS among women.

Limitations

Findings from this single-institution study have yet to be validated by other research groups.

Conclusions

The implications of TILs in predicting SLN positivity appear to be more relevant for men than for women.

中文翻译：

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肿瘤浸润淋巴细胞对原发性黑色素瘤的预后意义因性别而异

背景

对黑色素瘤的免疫反应通过肿瘤浸润淋巴细胞（TILs）局部显示。众所周知，男人和女人的免疫方式各不相同，但尚未探讨TIL的性别特异性预后意义。

方法

确定了在我院接受过临床定位为Breslow厚度为0.76 mm或更大的原发性黑色素瘤并进行了前哨淋巴结（SLN）活检的患者。TIL（无，无轻度和轻快）与SLN阳性之间的关联通过逻辑回归进行评估。通过TIL状态和性别评估总生存期（OS）。

结果

在确定的1367名患者中，有794名是男性。TIL在143个病灶中表现活跃，在903个病灶中呈无畸形，在321个病灶中不存在，这在性别上没有差异（P  = .71）。男性的SLN阳性与TIL相关（轻度为3.8％；非轻度为16.9％；不存在为26.6％[ P <.001]）。相比之下，女性的SLN阳性与TIL之间没有关联（P  = 0.49）。活跃的TIL和性别之间对SLN阳性的相互作用很显着（P  = .029）。在男性中，轻度TIL的存在与OS延长有关（P  = .038），但在调整SLN状态后却没有相关性（P  = .42）。妇女的TIL状况与OS之间没有关联。

局限性

这项单一机构研究的结果尚未得到其他研究小组的证实。

结论

TILs在预测SLN阳性中的意义似乎与男人比对女性更相关。