Evaluation of the pattern of presentation of tumor infiltrating lymphocytes and markers of the immune response in endometrial carcinomas.

• Grant number: 23/07383-4
• Support Opportunities: Scholarships in Brazil - Scientific Initiation
• Effective date (Start): October 01, 2023
• Effective date (End): September 30, 2024
• Field of knowledge: Health Sciences - Medicine
• Principal Investigator: Júlio César Teixeira
• Grantee: Leandro Vasconcelos
• Host Institution: Centro de Atenção Integral à Saúde da Mulher (CAISM). Hospital da Mulher Professor Doutor José Aristodemo Pinotti. Universidade Estadual de Campinas (UNICAMP). Campinas , SP, Brazil

Abstract

Introduction: Endometrial carcinomas (EC) can be classified by histopathological types or, more recently, by molecular categories such as those based on tumor-related immune response. There is evidence that the modulation of the immune response can favor or oppose tumor development and evolution. Some markers of the immune response and targeted therapies are already available, although not very accessible due to difficulties in the definition of the best case and cost. Thus, there is a search for alternatives that can help in the correlation of uterine neoplasms prognosis, such as assessing tumor infiltrating lymphocytes (TILs) and their correlation with markers of the immune response, such as programmed cell death protein 1 and its ligands 1 and 2. Objectives: To evaluate the presence and presentation pattern of TILs and their correlation with immunohistochemical markers of the immune response in EC. Methods: a cohort study will be carried out with a subgroup of cases participating in an ongoing institutional study to evaluate 39 biomarkers of uterine body neoplasms. Tissue samples from tumor biopsies stored in the institutional Pathology Laboratory will be studied. The sample size calculation set the significance level at 5% (alpha=0.05) and the sample power at 80% (beta=0.20), resulting in 170 cases. Paraffin histological blocks with EC will be identified, revised, selected, marked and directed to immunohistochemical assays. The resulting slides will be scanned, digitized and analyzed quantitatively and qualitatively by specific routine pathology software. Statistical analysis will correlate the pattern of lymphocytic infiltrate, type of lymphocyte present and expression of PD1, PD-L1 and PD-L2 markers with age, histological subtypes and staging. According to the sample distribution, the association between variables will be tested using Ç2, Fisher's exact, or Mann-Whitney tests.