Expression of Cathepsin L in tumor cells and tumor-associated macrophages in patients with Ewing sarcoma family of tumors: A pilot study.
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Date
2015-04
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Abstract
Background: Cysteine protease Cathepsin L is involved in bone remodeling
and expressed in activated macrophages. It is highly expressed in metastatic
tumor tissue, especially with bone metastases. Aims: We evaluated
immunohistochemical expression of Cathepsin L in tumor cells and tumorassociated
macrophages (TAMs) in chemo-naive Ewing sarcoma. Settings and
Design: Retrospective evaluation of archived specimens of Ewing sarcoma.
Materials and Methods: Immunohistochemical staining was performed on
archived blocks of chemo-naive patients with Ewing sarcoma treated with uniform
chemotherapy at our institute between January 2009 and November 2011.
Statistical Analysis: Immunohistochemical expression was co-related with
baseline demographics and survival. Results: During the study period, we had
evaluable baseline samples from 62 patients with median age 15 years (range:
2-40); 26 (42%) had metastases. Cathepsin L expression in tumor cells was
observed in 8/62 (13%) specimens. None of the baseline clinical characteristics
correlated with Cathepsin L expression. Cathepsin L positivity was associated
with poor response to neoadjuvant chemotherapy (NACT) (P = 0.05), but did
not infl uence either event-free-survival (EFS) or overall survival. Cathepsin L
was expressed in TAMs in all specimens. Grade 3 TAMs (>10 TAMs/high power
fi eld) was associated with better response to NACT (P = 0.05). On univariate
analysis Grade 3 TAMs predicted superior EFS (median EFS 28.5 months in
those with Grade 3 TAMs versus 14.8 months in those with grade ½ TAMs
[P = 0.04]). Conclusions: Cathepsin L expression by immunohistochemistry
was low in our patient cohort, and it did not affect the outcome. In addition,
Grade 3 TAMs with Cathepsin L expression was associated with improved EFS.
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Keywords
Cathepsin L, Ewing’s sarcoma, immunohistochemistry, tumorassociated macrophage
Citation
Biswas Bivas, Sharma Mehar Chand, Mridha Asit Ranjan, Bakhshi Sameer. Expression of Cathepsin L in tumor cells and tumor-associated macrophages in patients with Ewing sarcoma family of tumors: A pilot study. Indian Journal of Pathology & Microbiology. 2015 Apr-Jun 58(2): 170-174.