J Pathol Transl Med.  2023 Mar;57(2):88-94. 10.4132/jptm.2022.11.06.

Significance of tumor-associated neutrophils, lymphocytes, and neutrophil-to-lymphocyte ratio in non-invasive and invasive bladder urothelial carcinoma

• Hassan WA
• ElBanna AK
• Noufal N
• El-Assmy M
• Lotfy H
• Ali RI

• KMID: 2540494
• DOI: http://doi.org/10.4132/jptm.2022.11.06

Abstract

Background
Tumor-infiltrating neutrophils and lymphocytes play essential roles in promoting or combating various neoplasms. This study aimed to investigate the association between tumor-infiltrating neutrophils and lymphocytes and the neutrophil-to-lymphocyte ratio in the progression of urothelial carcinoma.
Methods
A total of 106 patients diagnosed with urothelial carcinoma were was. Pathological examination for tumor grade and stage and for tumor-infiltrating neutrophils, both CD4 and CD8+ T lymphocytes, as well as the neutrophil- to-lymphocyte ratio were evaluated.
Results
The presence of neutrophils and the neutrophil-to-lymphocyte ratio correlated with high-grade urothelial neoplasms. In both low- and high-grade tumors, the lymphocytes increased during progression from a non-invasive neoplasm to an early-invasive neoplasm. CD8+ T lymphocytes increased in low-grade non–muscle-invasive tumors compared to non-invasive tumors. Additionally, there was a significant decrease in CD8+ T lymphocytes during progression to muscle-invasive tumors.
Conclusions
Our results suggest that tumor-infiltrating neutrophils and CD8+ T lymphocytes have a significant effect on tumor grade and progression.

Keyword

Bladder urothelial carcinoma; Tumor-associated lymphocyte; Tumor-associated neutrophil; Neutrophil-lymphocyte ratio

Figure

• 

  Fig. 1 Tumor-associated neutrophils and CD8+ lymphocytes in non-invasive urothelial carcinoma. (A) Representative hematoxylin and eosin (H&E)-stained section of a low-grade papillary (arrows) non-invasive urothelial carcinoma. (B) Higher magnification of the base of the tumor reveals an abundance of lymphocytes (arrows) with few neutrophils (arrowheads). (C) Immunohistochemically, the lymphocytes express CD8 protein (arrows).

• 

  Fig. 2 Tumor-associated neutrophils and CD8+ lymphocytes in non–muscle-invasive urothelial carcinoma. (A) Representative hematoxylin and eosin–stained section of a lamina propria (non-muscle) invasive urothelial carcinoma. Tumor tissue grows as nests of malignant urothelial cells (arrows) infiltrating the lamina propria. (B) Higher magnification of the tumor stroma reveals an abundance of lymphocytes (arrows), with few neutrophils (arrowheads). (C) Immunohistochemically, many lymphocytes express CD8 protein (arrows).

• 

  Fig. 3 Tumor-associated neutrophils and CD8+ lymphocytes in muscle-invasive urothelial carcinoma. (A) Representative hematoxylin and eosin–stained section of muscle-invasive urothelial carcinoma. Tumor tissue grows as nests of malignant urothelial cells (black arrows) infiltrating the muscle layer (red arrows). (B) Higher magnification of the tumor stroma reveals an abundance of neutrophils (black arrows) with few lymphocytes (arrowheads). Immunohistochemically (C), few lymphocytes express CD8 protein (arrowheads).

Reference

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