CEYHAN UĞURLUOĞLU, SÜLEYMAN BALDANE, MUSLU KAZIM KÖREZ, MESUT BAYER
Turkish Journal of Oncology - 2023;38(2):127-135
OBJECTIVE Thyroid cancer is the most common endocrine neoplasm. About 10% develop invasive disease and 5% lymph node (LN) metastasis. An alternative immunoscore system to the tumor node metastasis (TNM) classification has been developed to predict the prognosis of solid tumors. The aim of this study is to investigate the potential roles of CD3+, CD8+ T lymphocyte infiltration and programmed death-ligand 1 (PD-L1) expression in immunoscore, the prognostic value of Immunoscore for Papillary thyroid cancer and its support for TNM classification. METHODS A total of 164 patients diagnosed with papillary thyroid cancer were included in our study. Immunoscore was evaluated by immunohistochemistry according to CD3+ and CD8+ T lymphocyte density at the tumor center and at the tumor margin. Immunoscore values were calculated. PD-L1 was evaluated by immunohistochemistry according to its density at the tumor center and at the tumor margin. The relationships between the parameters studied were evaluated statistically. RESULTS The presence of PD-L1 at the tumor centers in CD8+ T lymphocytes height was also significantly higher (p<0.001). There was no significant relationship between PD-L1 expression at the tumor center and LN metastasis and tumor size ( p>0.999 and p=0.226, respectively). In the presence of PD-L1 expression at the tumor margin, LN metastasis (p<0.001) and tumor size (p=0.029) were higher. PD-L1 expression at the tumor margin was significantly associated with overall survival (p<0.001). CONCLUSION In particular, immunoscore value can be a good prognostic marker and its significant association with conditions associated with poor prognosis, such as PD-L1 expression, suggests that it may be a parameter that can be used and guided in stage scoring.