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Immunocyte density in parathyroid carcinoma is correlated with disease relapse

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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.

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Data availability

All related data in this manuscript are stored and can be accessed in our database of hyperparathyroidism.

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Funding

This work was supported by the Chinese Academy of Medical Sciences (CAMS) Initiative for Innovative Medicine (CAMS-I2M) (2017-I2M-1-001), Peking Union Medical College Innovative Team Development Program (2016) and Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences (2018PT32014).

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Author notes

  1. Y. Hu and M. Cui have contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Y. Hu, M. Cui, X. Zhang, M. Wang, S. Hua, Q. Liao & Y. Zhao

  2. Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China

    Y. Bi

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  1. Y. Hu
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Correspondence to Q. Liao or Y. Zhao.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Institutional Ethics Review Board of Peking Union Medical College Hospital (S-K624). All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Hu, Y., Cui, M., Bi, Y. et al. Immunocyte density in parathyroid carcinoma is correlated with disease relapse. J Endocrinol Invest 43, 1453–1461 (2020). https://doi.org/10.1007/s40618-020-01224-6

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  • DOI: https://doi.org/10.1007/s40618-020-01224-6

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