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.

中文翻译：

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甲状旁腺癌中的免疫细胞密度与疾病复发相关。

目的

甲状旁腺癌（PC）是一种内分泌恶性肿瘤，预后较差。肿瘤免疫微环境是影响多种癌症类型结果的关键因素。但是，对PC中免疫微环境的了解仍然有限。

方法

通过免疫组织化学方法对51例PC病人样品中免疫细胞的肿瘤内密度和Ki-67指数进行了评估，并将其与临床病理特征和副纤蛋白染色结果进行了比较。Kaplan–Meier方法和Cox比例风险分析用于评估这些变量对临床结果的影响。

结果

肿瘤内免疫细胞密度与年龄，性别，尿石症或触及颈部肿块无关。Ki-67指数与CD3 ⁺细胞（P  = 0.022）和CD8 ⁺细胞（P  = 0.021）的肿瘤内密度以及血清钙水平（P  = 0.022）相关。在原发灶的肿瘤内区域，Kaplan–Meier方法显示与复发/转移相关的危险因素是低密度的CD3 ⁺（P  = 0.017），CD8 ⁺（P  = 0.019）和CD45 ⁺细胞（P  = 0.047 ），高密度的CD163 ⁺细胞（P = 0.003）和高Ki-67指数（P  = 0.004）。Cox回归多元分析显示CD163 ⁺细胞密度（危险比（HR）16.19，95％置信区间（CI）1.99-131.66；P  = 0.009）和CD8 ⁺细胞密度（HR 0.13，95％CI 0.02-0.76，P  = 0.024）是与PC复发相关的独立因素。

结论

免疫微环境是影响PC复发的重要因素。PC患者的CD3 ⁺，CD8 ⁺，CD45 ⁺和CD163 ⁺免疫细胞的肿瘤内密度与无病生存期（DFS）相关。基于T淋巴细胞或肿瘤相关巨噬细胞的免疫疗法可能是一种有前途的治疗策略。