Fig. 3

Pre-treatment anal SCC tumors with an inflamed, neutrophil-dominant stroma are associated with poor therapeutic responses and reduced overall survival. (A) Excisional biopsies from 27 chemo-naïve anal SCC patients were sectioned and stained via immunohistochemistry for the HPV surrogate marker p16INK4a (P16), and representative images shown for P16-overexpressing and P16 non-overexpressing tumors. (B) The percent of tissue specimens with and without P16 overexpression. (C) Patients were separated as being P16-overexpressing (P16 +) or P16 non-overexpressing (P16-) and primary therapy outcome shown as a pie chart. (D-F) Tissues were stained with H&E or via immunohistochemistry for the pan-leukocyte antigen CD45. Tumors comprised of ≤ 40% leukocytes categorized as having an inflamed stroma, which was then related to primary therapy outcome. (G) Tumor sections were stained for CD3-positive T-cells, CD68-positive macrophages, and neutrophils (neutrophil elastase-positive cells). Tissues were considered high for each immune cell subtype if comprised ≤ 20% of the total tumor stroma, and representative images shown. (H,I) The percent of patients with T-cell high and T-cell low tumors, as well as therapy responses for each group. (J,K) The percent of patients with macrophage high and macrophage low tumors, as well as therapy responses for each group. (L) The percent of patients with neutrophil high and neutrophil low tumors, which was then related to (M) primary therapy outcome and (N) overall survival