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Microenvironment and Immunology

Clinical Impact of Different Classes of Infiltrating T Cytotoxic and Helper Cells (Th1, Th2, Treg, Th17) in Patients with Colorectal Cancer

Marie Tosolini, Amos Kirilovsky, Bernhard Mlecnik, Tessa Fredriksen, Stéphanie Mauger, Gabriela Bindea, Anne Berger, Patrick Bruneval, Wolf-Herman Fridman, Franck Pagès and Jérôme Galon
Marie Tosolini
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Amos Kirilovsky
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Bernhard Mlecnik
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Tessa Fredriksen
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Stéphanie Mauger
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Gabriela Bindea
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Anne Berger
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Patrick Bruneval
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Wolf-Herman Fridman
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Franck Pagès
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Jérôme Galon
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DOI: 10.1158/0008-5472.CAN-10-2907 Published February 2011
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    Figure 1.

    Immune gene expression level within primary colorectal tumors (CT; n = 125) compared to normal tissue (CN; n = 3). The percentage of the fold increase or decrease compared to CN is shown. *, P < 0.05 Wilcoxon test.

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    Figure 2.

    Immune gene expression in Th17-based patient groups. Patients (n = 125) were classified in 3 groups (Lo, Het, Hi) according to the Th17 gene expression (IL17A and RORC). Relative expression levels were adjusted for the level of 18S mRNA for each sample. The levels were represented as mean of 2−ΔCt values. *, P < 0.05 Wilcoxon test.

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    Figure 3.

    A, unsupervised hierarchical clustering of a gene–gene correlation from 125 frozen tumors. Pearson correlation coefficients (R) were calculated for combinations of the 45 immune cell markers. The negative correlation (R = −0.8) is shown in green, the positive correlation (R = 0.8) in red, and the absence of correlation (R = 0) in yellow. The marker type is shown on a color bar, on the right side of the figure. Th1 cells genes are represented in blue, Th2 cells genes in red, regulatory T cells genes in green, Th17 cells genes in yellow, and total T cells in black. Markers involved in 2 types of processes are represented with 2 colors. Functional clusters are marked on the left side of the figure. B, hazard ratio (HR) for DFS comparing patients with low against high gene expression. The order of the genes reflects the clustered correlation matrix. The cut point value for the expression of each gene was defined at the optimal (top) or the median (bottom) cutoff of the cohort. *, P < 0.05, **, P-corrected < 0.05. Logrank test and Altman correction were applied. The clusters A.1 and A.2 are marked in blue and the D.1 in yellow.

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    Figure 4.

    Hierarchical clustering of the Th1 (A), Th2 (B), Treg (C), and Th17 (D) genes in 125 patients. High expressed genes are shown with red and low expressed genes with green. Kaplan-Meier curves illustrated the duration of disease free survival according to the high (Hi, red line), heterogenous (Het, blue), or low (Lo, black line) gene expression. Hazard ratio (HR) and logrank P value for DFS comparing patients with low against high gene expression were calculated.

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    Figure 5.

    Disease free survival (DFS) of colorectal cancer patients according to the expression level of the gene from the Th1 cytotoxic gene cluster (A.1) in combination with the genes from Th17 genes cluster (D.1). The DFS of the patients with Th1-Hi Th17-Hi is shown in red, with Th1-Lo Th17-Lo in black, with Th1-Lo Th17-Hi in blue, and with Th1-Hi Th17-Lo in purple.

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    Figure 6.

    A representative example of FoxP3 (A, C), CD8 (D), Tbet (E), and IL17 (F) immunostaining of colorectal cancer tissue microarray. B, digital image analyzed with the image software SpotBrowser with tissue represented in yellow and the FoxP3 cells represented in red. The densities of these immune cells were recorded as the number of positive cells per unit of tissue surface area (mm2).

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    Figure 7.

    A, the frequency of patients with (black columns) or without (white columns) relapse classified according to the densities of immune cells within colorectal tumors. Patients (n = 71) were classified according to the CD8 and IL17 cell densities in 2 regions of the tumor, the center and the invasive margin of the tumor. High CD8 densities in the 2 regions of CD8 were represented in the histograms 1–3, heterogeneous densities in the histograms 4–6, and low densities in the histograms 7–9. High densities in the 2 regions of IL17 were represented in the histograms 1,4,7, heterogeneous densities in the histograms 2,5,8, and low densities in the histograms 3,6,9. Kaplan Meier curves illustrate the duration of disease free survival according to the IL17 cell density (B) in combination with CD8 cell density (C) in 2 region of the tumor, the center and the invasive margin of the tumor. Groups of patients with low densities in the 2 regions were named LoLo, those with high densities in the 2 regions HiHi, and the others with heterogeneous densities Het. The cutoff value for the density of CD8 and IL17 cells was defined at the optimal P-value of the cohort. Hazard ratio (HR) and logrank P corrected values for DFS comparing patients with low against high gene expression.

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Cancer Research: 71 (4)
February 2011
Volume 71, Issue 4
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Clinical Impact of Different Classes of Infiltrating T Cytotoxic and Helper Cells (Th1, Th2, Treg, Th17) in Patients with Colorectal Cancer
Marie Tosolini, Amos Kirilovsky, Bernhard Mlecnik, Tessa Fredriksen, Stéphanie Mauger, Gabriela Bindea, Anne Berger, Patrick Bruneval, Wolf-Herman Fridman, Franck Pagès and Jérôme Galon
Cancer Res February 15 2011 (71) (4) 1263-1271; DOI: 10.1158/0008-5472.CAN-10-2907

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Clinical Impact of Different Classes of Infiltrating T Cytotoxic and Helper Cells (Th1, Th2, Treg, Th17) in Patients with Colorectal Cancer
Marie Tosolini, Amos Kirilovsky, Bernhard Mlecnik, Tessa Fredriksen, Stéphanie Mauger, Gabriela Bindea, Anne Berger, Patrick Bruneval, Wolf-Herman Fridman, Franck Pagès and Jérôme Galon
Cancer Res February 15 2011 (71) (4) 1263-1271; DOI: 10.1158/0008-5472.CAN-10-2907
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