Polymorphismes des gènes associés à l’inflammation et microenvironnement tumoral lymphocytaire CD8+ : valeur pronostique dans les carcinomes urothéliaux de la vessie.

Abstract : The aim of this study was to explore prognostic value for bladder cancer of germline polymorphisms in inflammatory genes and tumor CD8+ lymphocytic microenvironment. For constitutional markers, two approaches were conducted jointly: one genome-based using specific GWAS statistical methods, the other gene-based focusing on PDL1, an inflammatory gene implicated in immune checkpoints. At the genome level, using both standard and innovative statistical methods (multi marker methods Bayesian Lasso and Bayes A) we demonstrated that variants (SNPs) in TNIP1, CD5 and JAK3 were associated with the risk of recurrence of non-muscle invasive bladder cancer (NMIBC) while SNPs in MASP1, AIRE and CD3 were associated with risk of progression. Meanwhile, association between PDL1 and prognosis of NMIBC and muscle invasive BC (MIBC) was explored using classical SNPS by SNP investigations and a gene based approach. We identified a very strong association between PDL1 variants and MIBC prognosis in a large prospective cohort but failed replicating those results in the TCGA consortium series.In non-muscle invasive bladder cancer, we developed and evaluated a standardized counting approach of CD8+ cells, T-cytotoxic lymphocytes implicated in tumor cells death. Morphometric analysis after double immuno-staining of tumor cells and digitalization allowed separate estimation of CD8+ cells in the tumor and stroma compartment and estimation of spatial intra tumoral heterogeneity. We demonstrated that this heterogeneity compromised CD8+ estimation on Tissue Micro Arrays, which sample the tumors in a restrictive manner. Keeping those limitations in mind, we identified an association between CD8+ inflammatory infiltrate and both NMIBC stage and T1 tumours risk of recurrence. In the future, germline variation in inflammatory genes and evaluation of tumor inflammatory infiltrate could be integrated for better prediction of bladder cancer prognosis.
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Submitted on : Thursday, November 29, 2018 - 4:53:06 PM
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Alexandra Masson Lecomte. Polymorphismes des gènes associés à l’inflammation et microenvironnement tumoral lymphocytaire CD8+ : valeur pronostique dans les carcinomes urothéliaux de la vessie.. Médecine humaine et pathologie. Université Paris-Est, 2017. Français. ⟨NNT : 2017PESC0073⟩. ⟨tel-01939721⟩

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