Background and objectives: Solitary fibrous tumors (SFTs) are morphologically heterogeneous tumors characterized by theNAB2::STAT6gene fusion. Clinical outcomes may vary widely, and while most cases have favorable outcomes, some can progress to aggressive disease, manifesting as recurrence and metastasis, and ultimately resulting in patient death. Herein, we analyze the immunological tumor microenvironment (ITME) of SFTs, aiming to determine its prognostic value and correlation with established risk stratification systems (RSSs). Methods: A retrospective observational multicenter study of 52 fusion-confirmed SFTs with clinical follow-up data. Immunohistochemical analysis including CD163, CD68, CD3, CD8, CD20, PDL-1, PD-1, and LAG1 were evaluated in tissue microarrays, using an analog scale with scores ranging from 0 to 3 (0 = ≤9, 1 = 10–49, 2 = 50–99, and 3 = >100 positive cells per 10 high-power fields). The expression of these markers was correlated with clinical outcomes, morphological characteristics previously evaluated in whole slide tissue sections (hypercellularity/hypocellularity, round–oval or spindle dominant constituent cell (DCC) morphology, and necrosis), Ki67, overall survival, and RSS. Results: Only one of the fifty-two cases studied showed progression. In the multivariate analysis, neither the presence nor absence of immune cells (B-lymphocytes, T-lymphocytes, and macrophages) showed any association with the assessed RSSs (Demicco, Sugita, G-score, and Huang). Interestingly, the case that showed progression had high immune infiltrate with expression of CD68, CD163, CD8, and CD20 markers (score of 3). Round–oval cell morphology was associated with the presence of higher levels of CD163 macrophages. Lastly, the scant presence of CD20+ lymphocytes correlated with less necrosis, and cases with higher PDL-1 expression correlated with increased Ki67 values. All cases were negative for LAG-1 and PD-1. Conclusions: SFT ITME components correlated with independent variables with prognostic significance. Nevertheless, ITME did not correlate with RSS scores.
背景与目的：孤立性纤维性肿瘤（SFT）是一种形态学异质性肿瘤，其特征为NAB2::STAT6基因融合。临床结局差异显著，多数病例预后良好，但部分可进展为侵袭性疾病，表现为复发和转移，最终导致患者死亡。本研究旨在分析SFT的免疫肿瘤微环境（ITME），评估其预后价值及其与现有风险分层系统（RSS）的相关性。方法：对52例经基因融合确诊且具有临床随访数据的SFT进行回顾性多中心观察研究。通过组织芯片进行免疫组化分析，检测指标包括CD163、CD68、CD3、CD8、CD20、PD-L1、PD-1和LAG1，采用0-3分模拟评分（0=≤9个、1=10-49个、2=50-99个、3=>100个阳性细胞/10个高倍视野）。将上述标志物表达与临床结局、全切片组织学特征（细胞丰富/稀疏、圆形-卵圆形或梭形优势细胞形态、坏死）、Ki67指数、总生存期及RSS评分进行相关性分析。结果：52例中仅1例出现疾病进展。多变量分析显示，免疫细胞（B淋巴细胞、T淋巴细胞和巨噬细胞）的存在与否与评估的RSS系统（Demicco、Sugita、G评分和Huang系统）均无关联。值得注意的是，出现进展的病例呈现高免疫浸润状态，CD68、CD163、CD8和CD20标志物表达均为3分。圆形-卵圆形细胞形态与高水平CD163+巨噬细胞存在相关。此外，CD20+淋巴细胞稀少与坏死程度较低相关，而PD-L1高表达病例与Ki67指数升高相关。所有病例LAG-1和PD-1表达均为阴性。结论：SFT的ITME成分与具有预后意义的独立变量相关，但ITME与RSS评分无显著相关性。
肿瘤(癌症)患者之家