In the present study, we investigated the clinicopathologic significance<br />of intratumoral lymphoplasmacytic infiltration in a large cohort of<br />patients with solitary hepatocellular carcinoma (HCC). Based on<br />examination of hematoxylin and eosin-stained sections, significant<br />infiltration was defined as dense lymphoplasmacytic infiltration, either<br />multifocal or diffuse, in 2 or more fields under low-power<br />magnification. Of 544 cases, 216 (39.7%) were positive for significant<br />infiltration (HCC-LI group), while 328 (60.3%) were negative (HCC-NLI<br />group). There were no significant between-group differences in patient<br />age, sex, or background etiology. The lower incidence of Child-Pugh<br />stage B (P = 0.001) and lower level of indocyanine green retention rate<br />at 15 minutes (P < 0.001) in the HCC-LI group indicated better liver<br />function in this group. Histologically, tumors were significantly<br />smaller in size in the HCC-LI group than in the HCC-NLI group (P <<br />0.001). In addition, prominent neutrophilic infiltration, interstitial<br />fibrosis and tumor steatosis were significantly more frequent (P <<br />0.001) in the HCC-LI group, while tumor necrosis was significantly less<br />frequent (P = 0.008). Kaplan-Meier analyses revealed that overall and<br />recurrence-free survival were significantly better in the HCC-LI group<br />(P < 0.001). Multivariate Cox regression analysis showed that<br />intratumoral lymphoplasmacytic infiltration was independently prognostic<br />of both overall and recurrence-free survival (P < 0.001), with absence<br />of infiltration showing high Cox-hazard ratios for poor prognosis. In<br />conclusion, intratumoral lymphoplasmacytic infiltration, as determined<br />by assessment of hematoxylin and eosin-stained slides, was significantly<br />associated with the clinical and pathologic features of HCC and has<br />profound prognostic importance.
Hayashi, A., Shibahara, J., Misumi, K., Arita, J., Sakamoto, Y., Hasegawa, K., … Fukayama, M. (2016). Histologic assessment of intratumoral lymphoplasmacytic infiltration is useful in predicting prognosis of patients with hepatocellular carcinoma. PLoS ONE, 11(5). https://doi.org/10.1371/journal.pone.0155744