Indoleamine 2, 3-Dioxygenase (IDO) Expression Is an Independent Prognostic Marker in Esophageal Adenocarcinoma. (22nd September 2020)

• Record Type: Journal Article
• Authors: Loeser, Heike; Kraemer, Max; Gebauer, Florian; Bruns, Christiane; Schröder, Wolfgang; Zander, Thomas; Alakus, Hakan; Hoelscher, Arnulf; Buettner, Reinhard; Lohneis, Philipp; Quaas, Alexander
• Other Names: Jadeja Ravirajsinh Academic Editor.
• Is Part Of: Journal of immunology research. Volume 2020(2020)
• Publication Date: 2020-09-22
• Subjects: Immunology -- Periodicals; Immunology -- Research -- Periodicals; 616.07905
• DOI: 10.1155/2020/2862647
• Languages: English
• ISSNs: 2314-8861

Abstract

Abstract : Background . Indoleamine 2, 3-dioxygenase (IDO) is an interferon-inducible immune checkpoint expressed on tumor-infiltrating lymphocytes (TILs). IDO is known as a poor prognostic marker in esophageal squamous cell cancer, while a positive effect was shown for breast cancer. A comprehensive analysis of IDO expression in a well-defined cohort of esophageal adenocarcinoma (EAC) is missing. Methods . We analyzed 551 patients with EAC using single-protein and multiplex immunohistochemistry as well as mRNA in situ technology for the expression and distribution of IDO on subtypes of TILs (INF- γ mRNA and CD4- and CD8-positive T lymphocytes). Results . IDO expression on TILs was seen in up to 59.6% of tumors, and expression on tumor cells was seen in 9.2%. We found a strong positive correlation of IDO-positive TILs, CD3-positive T lymphocytes, and INF- γ mRNA-producing TILs in the tumor microenvironment of EACs showing significantly better overall survival (47.7 vs. 22.7 months, p < 0.001 ) with emphasis on early tumor stages (pT1/2: 142.1 vs. 37.1 months, p < 0.001 ). In multivariate analysis, IDO is identified as an independent prognostic marker. Conclusions . Our study emphasizes the importance of immunomodulation in EAC marking IDO as a potential biomarker. Beyond this, IDO might indicate a subgroup of EAC with an explicit survival benefit.