Avaliação de linfócitos no estroma peritumoral de neoplasias epitelais de ovário

Abstract

OBJECTIVES: Ovarian cancer is a heterogeneous disease, where chronic inflammation is one of the central mechanisms of its pathogenesis. The location, subtype and density of Lymphocyte Tumor Infiltrators (TILs) are the main determinants of this prognostic value. The objectives of the study were to evaluate the expression of CD3, CD4, CD8 and CD20 in the peritumoral stroma of benign and malignant primary ovarian epithelial neoplasms and to relate them to prognostic factors (serum levels of tumor markers, histological type, lymph node involvement, response to chemotherapy, disease-free survival, staging, and degree of tumor differentiation) in ovarian cancer. PATIENTS AND METHODS: We evaluated 77 patients treated at the Pelvic Mass Outpatient Clinic of the Department of Gynecology and Obstetrics / Institute of Oncology Research (IPON) of the Federal University of Triângulo Mineiro. Immunohistochemistry study for cytokines (CD3, CD4, CD8 and CD20) was performed. The evaluation of prognostic factors was performed using the Fisher's exact test. The significancelevelwas less than 0.05. RESULTS: A higher CD3 expression was found in the stroma of primary ovarian malignancies when compared to the group of benign neoplasms, and greater expression of CD4 cells in the stroma of benign neoplasms compared to ovarian cancer. By correlating the expression of cytokines with prognostic factors, there was a greater expression of CD8 cells in the stromal ovarian malignancies with molecular subtype II of the model of epithelial ovarian carcinogenesis compared to type I. In the evaluation of lymph node metastases, the absence of immuno-labeling of CD20 cells was associated with the absence of lymph node metastases. CONCLUSION: The immune system plays a multifaceted role and can, in different contexts, promote or inhibit tumor growth. Increased immunostaining of CD3 is found in malignant neoplasms, while increased CD4 immunostaining is associated with benign ovarian neoplasms. CD8 immunostaining was greater in type II tumors, while the absence of CD20 immunostaining was associated with the absence of lymph node metastases.