The utility of tumour infiltrating lymphocytes as a risk factor for local recurrences of abdominal wall fibromatosis

Abstract

Background: Desmoid-type fibromatosis (DF) is a locally aggressive tumour of fibroblastic/myofibroblastic origin that usually occurs in young adults. Extra-abdominal tumours (including abdominal wall tumours) is a biologically different type with special aetiology, behaviour, and the morbidity associated. Abdominal wall fibromatosis comprises a major sector of fibromatosis cases. Until now few risk factors have been documented as predictors of tumour recurrences in this type. Aim: In the current study we proposed that the nature of the lymphocytic infiltrate in fibromatosis may provide a novel risk factor for predicting recurrences and may provide a novel approach for immunotherapy. Methods: Forty retrospective cases of abdominal wall desmoid tumours were collected from two hospitals from cases from 2011 to 2014. Cases were divided into two groups according to occurrence of recurrences in the period of 5 years (until 2019). Sections from the tumour were stained for immunohistochemical markers for CD4 and CD8. The number of positive cells for each marker was examined in 5 high power fields, both in tumour invading margin and tumour core using image analysis system. Results: Higher density of CD4 and CD8 T lymphocytes were found in cases of non-recurrent cases group (p<0.05). The tumour margin CD4 and CD8 cells were more associated with non-recurrent cases that intra-tumoural (core) cells (p<0.05). Conclusion: The study concluded that high CD4 and CD8 positive T lymphocytes mainly in the tumour margins are associated with favourable recurrence-free survival in abdominal wall fibromatosis and may present a portal for future immunotherapy for these cases.