Prognostic impact of spatial distances between immune cells and tumor cells in acral melanoma
Objective To investigate the relationship between the spatial distance of immune cells to tumor cells and patient prognosis in acral melanoma.Methods Clinical data and pathological specimens were collected from 39 patients diagnosed with acral melanoma who underwent primary tumor resection at Nanjing Drum Tower Hospital between January 2013 and December 2021.Multiplex immunofluorescence staining was used to detect the spatial distances between immune cells and tumor cells in the tumor microenvironment.Kaplan-Meier survival analysis was performed to evaluate the prognostic impact of the spatial proximity between CD4+T cells,CD8+T cells,CD68+macrophages,and SOX10+tumor cells.Cox proportional hazards regression models were used to identify independent factors affecting patients'prognosis.Results Among the 39 enrolled patients,18 were male and 21 were female,with a median age of 68 years.No significant differences were observed in the average spatial distances of CD4+T cells,CD8+T cells,and CD68+macrophages from SOX10+tumor cells when stratified by gender(male vs.female),age(≤68 years vs.＞68 years),or TNM stage(stage Ⅰ-Ⅱ vs.stage Ⅲ)(P＞0.05).Kaplan-Meier survival curves indicated that closer spatial proximity of CD4+T cells to SOX10+tumor cells was associated with better patient survival(P=0.028),while the spatial distance of CD4+T cells and CD68+macrophages to SOX10+tumor cells was not significantly related to patient survival(P＞0.05).The results of univariate and multivariate Cox regression analysis showed that TNM stage was an independent prognostic factor(P=0.05),while gender,the spatial distance between CD4+T cells and SOX10+tumor cells were not independent prognostic factors(P＞0.05).Conclusion The spatial proximity of CD4+and CD8+T cells to SOX10+tumor cells in the tumor microenvironment is indicative of better prognosis in acral melanoma patients.However,the spatial distance between CD4+T cells or CD8+T cells and SOX10+tumor cells is not an independent prognostic factor.
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