The Predictive Role of Immunohistochemical FoxP3 and CD163 Expression in Response to Neoadjuvant Therapy of Rectal Carcinomas
Ozlem Ozdemir1, Asuman Argon2, Savas Yakan3, Tarik Salman4, Cengiz Yilmaz1, Ahmet Alacacioglu41Departments of Medical Oncology, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye, 2Departments of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye Departments of Pathology, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye, 3Departments of General Surgery, Izmir Bozyaka Training and Research Hospital, Izmir, Türkiye, 4Departments of Medical Oncology, Katip Çelebi University, Atatürk Training and Research Hospital, Izmir, Türkiye
Objectives: In the present study, we aim to investigate the predictive role of FoxP3 and CD163 expressions in biopsy samples for the neoadjuvant treatment, which are performed pretreatment due to locally advanced rectum cancer. Methods: The study included 70 patients who were operated post-neoadjuvant 5FU-based chemoradiotherapy (nCRT) in 2011-2019 due to locally advanced rectum cancer. Results: Forty-eight (68.6%) of the patients involved in our study were men and 22 (31.4%) were women. The median age was 64.81±10.16 years (37-84 years). For FoxP3, considering all the tumor areas in the biopsy material, the average number of FoxP3-positive lymphocytes was 12.37±11.68/1 HPF (median: 9.8; min: 0.2, max: 66). The number of CD163- positive macrophages was low in 30 (42.9%) tumors, and high in 40 (57.1%). As a result of regression evaluations, 16 (22.9%) cases were evaluated in Tumor Regression Grade (TRG) 1 category, 23 cases in TRG2, 12 cases in TRG3, 14 cases in TRG4 and 5 cases in TRG5 category. There was a significant relationship between the FoxP3 increase and the tumor regression grade, with no significant relationship between the intensity of CD 163 and the tumor regression grade. In addition, a significant relationship was found between the regression grade and tumor differentiation, perineurial invasion, positivity of surgical margin, residual tumor depth and lymphatic response. Conclusion: Our study supports that the T-cell-mediated immune response plays an important role in the tumor response to nCRT, and particularly the FOXP3+ TIL densities are associated with the pathological response to nCRT. Keywords: Rectal cancer, Fox P3, CD 163, Tumor regression Grade
Cite This Article
Ozdemir O, Argon A, Yakan S, Salman T, Yilmaz C, Alacacioglu A. The Predictive Role of Immunohistochemical FoxP3 and CD163 Expression in Response to Neoadjuvant Therapy of Rectal Carcinomas. EJMI. 2022; 6(4): 462-469
Corresponding Author: Ozlem Ozdemir