Research Program Unit, Medical Faculty, University of Helsinki, Finland;Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
Marjukka Pollari
Research Program Unit, Medical Faculty, University of Helsinki, Finland;Department of Oncology, Tampere University Hospital, Finland
Oscar Brück
Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland
Teijo Pellinen
Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland
Matias Autio
Research Program Unit, Medical Faculty, University of Helsinki, Finland;Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
Marja-Liisa Karjalainen-Lindsberg
Department of Pathology, Helsinki University Hospital, Finland
Susanna Mannisto
Research Program Unit, Medical Faculty, University of Helsinki, Finland;Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
Pirkko-Liisa Kellokumpu-Lehtinen
Department of Oncology, Tampere University Hospital, Finland;University of Tampere, Faculty of Medicine and Life Sciences, Finland
Olli Kallioniemi
Institute for Molecular Medicine Finland (FIMM), Helsinki, Finland;Science for Life Laboratory, Karolinska Institutet, Department of Oncology and Pathology, Solna, Sweden
Satu Mustjoki
Hematology Research Unit Helsinki, Department of Clinical Chemistry and Hematology, University of Helsinki, Finland;Department of Hematology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
Sirpa Leppä
Research Program Unit, Medical Faculty, University of Helsinki, Finland;Department of Oncology, Comprehensive Cancer Center, Helsinki University Hospital, Finland
Primary testicular lymphoma is a rare lymphoid malignancy, most often, histologically, representing diffuse large B-cell lymphoma. The tumor microenvironment and limited immune surveillance have a major impact on diffuse large B-cell lymphoma pathogenesis and survival, but the impact on primary testicular lymphoma is unknown. Here, the purpose of the study was to characterize the tumor microenvironment in primary testicular lymphoma, and associate the findings with outcome. We profiled the expression of 730 immune response genes in 60 primary testicular lymphomas utilizing the Nanostring platform, and used multiplex immunohistochemistry to characterize the immune cell phenotypes in the tumor tissue. We identified a gene signature enriched for T-lymphocyte markers differentially expressed between the patients. Low expression of the signature predicted poor outcome independently of the International Prognostic Index (progression-free survival: HR=2.810, 95%CI: 1.228-6.431, P=0.014; overall survival: HR=3.267, 95%CI: 1.406-7.590, P=0.006). The T-lymphocyte signature was associated with outcome also in an independent diffuse large B-cell lymphoma cohort (n=96). Multiplex immunohistochemistry revealed that poor survival of primary testicular lymphoma patients correlated with low percentage of CD3+CD4+ and CD3+CD8+ tumor-infiltrating lymphocytes (P
