性别、治疗策略、分子背景和 TIL（肿瘤浸润淋巴细胞）在胶质母细胞瘤中的预后影响：一个仍未解决的拼图

Despite the adoption of novel therapeutical approaches, the outcomes for glioblastoma (GBM) patients remain poor. In the present study, we investigated the prognostic impact of several clinico-pathological and molecular features as well as the role of the cellular immune response in a series of 59 GBM. CD4+ and CD8+ tumor-infiltrating lymphocytes (TILs) were digitally assessed on tissue microarray cores and their prognostic role was investigated.

Moreover, the impact of other clinico-pathological features was evaluated. The number of CD4+ and CD8+ is higher in GBM tissue compared to normal brain tissue ( p < 0. 0001 and p = 0. 0005 respectively). A positive correlation between CD4+ and CD8+ in GBM is present ( r s = 0. 417- p = 0. 001). CD4+ TILs are inversely related to overall survival (OS) (HR = 1. 79, 95% CI 1. 1-3. 1, p = 0. 035).

The presence of low CD4+ TILs combined with low CD8+ TILs is an independent predictor of longer OS (HR 0. 38, 95% CI 0. 18-0. 79, p = 0. 014). Female sex is independently related to longer OS (HR 0. 42, 95% CI 0. 22-0. 77, p = 0. 006). Adjuvant treatment, methylguanine methyltransferase ( MGMT ) promoter methylation, and age remain important prognostic factors but are influenced by other features. Adaptive cell-mediated immunity can affect the outcomes of GBM patients.

Further studies are needed to elucidate the commitment of the CD4+ cells and the effects of different TILs subpopulations in GBM.