Effect of intratumoral lymphocyte density on the disease-free survival and overall survival in malignant epithelial tumors of the ovary.

Malignant epithelial ovarian tumors are the fifth most common cancer of females which has the highest mortality rate among gynecological malignancies. Tumor-specific or related antigens that induce an immune response have been defined in tumors. Intratumoral T lymphocytes recognize these antigens and induce a cytolytic activity. Vascular endothelial growth factor (VEGF) is a potent angiogenic factor expressed in many tumors. In this study, we studied the relation between clinicopathological findings and intratumoral T lymphocyte and VEGF expressions in malignant epithelial ovarian tumors. The presence of VEGF in ovarian surface epithelial carcinomas and CD3, CD4 and CD8 antibodies in tumor-infiltrated lymphocytes were investigated in 63 cases with an immunohistochemical method. Positive-stained intratumoral lymphocytes were graded on a scale of 0 to 3 (0→0, + 1 →≤ 5, + 2→6-19, + 3→≥ 20). VEGF was assessed according to the staining intensity (0: negative, +1: weak, +2: moderate, +3: strong). CD3 positivity was observed in intratumoral lymphocytes in all cases while only CD4 and CD8 positivities were observed in 30% and 80%, respectively. VEGF was positive in 73% of the cases. No significant relation was observed between VEGF expression and presence of intratumoral T lymphocyte and clinicopathological parameters. Moreover, they did not have any significant effect on disease-free survival and overall survival.