Exploratory Pilot Study to Characterize the Immune Landscapes of Malignant Pleural Effusions and Their Corresponding Primary Tumors From Patients With Breast Carcinoma and Lung Adenocarcinoma

Authors

Caddie Laberiano-Fernandez
Qiong Gan
Sophia Mei Wang
Auriole Tamegnon
Ignacio Wistuba
Esther Yoon
Sinchita Roy-Chowdhuri
Edwin Roger Parra

Publication Date

1-1-2024

Journal

Journal of the American Society of Cytopathology

Abstract

Introduction: Malignant pleural effusion (MPE) is a frequent complication of advanced malignancies. In this pilot study, we characterized the immune landscapes of MPEs, compared them to their primary tumor (PT) samples from breast carcinoma (BC) and lung adenocarcinoma (LADC), and tested the utility of multiplexed image technology in cytological samples.

Materials and methods: We evaluated the immune contexture of 6 BC and 5 LADC MPEs and their PTs using 3 multiplex immunofluorescence panels. We explored the associations between sample characteristics and pleural effusion-free survival.

Results: No MPE samples had positive programmed death-ligand 1 expression in malignant cells, although 3 of 11 PTs has positive programmed death-ligand 1 expression (more than 1% expression in malignant cells). Overall, in LADC samples, cluster of differentiation 3 (CD3)+ T cells and CD3+CD8+ cytotoxic T cells predominated (median percentages for MPEs versus PTs: 45.6% versus 40.7% and 4.7% versus 6.6%, respectively) compared with BC. CD68+ macrophages predominated in the BC samples (medians for MPEs 61.2% versus PTs for 57.1%) but not in the LADC samples. Generally in PTs, CD3+CD8+ forkhead box P3+ T cells and the median distances from the malignant cells to CD3+CD8+Ki67+ and CD3+ programmed cell death protein 1 + T cells correlated to earlier MPE after PT diagnosis.

Conclusions: The immune cell phenotypes in the MPEs and PTs were similar within each cancer type but different between BC versus LADC. An MPE analysis can potentially be used as a substitute for a PT analysis, but an expanded study of this topic is essential.

Keywords

Humans, Female, Pilot Projects, Breast Neoplasms, Pleural Effusion, Malignant, Lung Neoplasms, Middle Aged, Aged, Adenocarcinoma of Lung, B7-H1 Antigen, Male, Adenocarcinoma, Adult, Aged, 80 and over, Biomarkers, Tumor, Breast, Cancer, Immunofluorescence, Lung, Microenvironment, Pleural effusion

DOI

10.1016/j.jasc.2024.02.005

PMID

38519275

PMCID

PMC11969369

PubMedCentral® Posted Date

4-4-2025

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes