我们旨在探讨肿瘤浸润淋巴细胞（TILs）在HPV（+）口咽癌患者的原发肿瘤和转移淋巴结中的预后价值。我们假设两个部位的TILs密度与HPV（+）口咽癌的无疾病生存率有关。我们进行了一项匹配病例-对照研究，包括接受意图治愈手术的HPV（+）口咽癌患者。病例发生局部复发或远处转移。对照组根据年龄、性别、病理T、N和总体期数、手术年份、接受的辅助治疗类型以及成人并发症评估-27（ACE-27）评分进行匹配。单个三级保健中心，时间范围为2007年5月至2016年12月。使用Cox回归模型评估TILs与疾病进展时间之间的关联。最终纳入44个病例-对照组（N = 88），其中42例（48％）AJCC pStage I，39例（44％）pStage II和7例（8％）pStage III。原发肿瘤的TILs密度≥10％（风险比[HR] 0.41，95％置信区间[CI] 0.17-0.99，p = .048）和适度/密集的间质TILs密度（HR为0.21，95％CI为0.06-0.75，p = .016）与进展风险明显相关。淋巴结中的TILs密度与进展风险降低有关但未达到统计学意义。原发肿瘤和淋巴结中的tTILs和sTILs密度之间呈强相关性。病理学家之间的一致性中等（60％-70％）。在HPV（+）口咽癌中，原发肿瘤和可能淋巴结中更高的肿瘤和间质TILs密度可能预测较低的疾病进展风险。© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.

We aim to explore the prognostic value of tumor-infiltrating lymphocytes (TILs) in the primary tumor and metastatic lymph nodes of patients with HPV(+)OPSCC. We hypothesize that TILS density at both sites is associated with disease-free survival in HPV(+)OPSCC.Matched case-control study among HPV(+)OPSCC patients who underwent intent-to-cure surgery. Cases developed locoregional or distant recurrence. Controls were matched based on age, sex, pathologic T, N, and overall stage, year of surgery, type of adjuvant treatment received, and the Adult Comorbidity Evaluation-27 (ACE-27) score.Single tertiary care center, May 2007 to December 2016.Tumoral TILs (tTILs) density was defined as % TILs; stromal TILs (sTILs) density was defined as absent/sparse or moderate/dense crowding. Associations between TILs and time to disease progression were assessed using Cox regression models.Forty-four case-control pairs (N = 88) were included: 42 (48%) AJCC pStage I, 39 (44%) pStage II, and 7 (8%) pStage III. tTILs density ≥10% (hazard ratio [HR] 0.41, 95% confidence interval [CI] 0.17-0.99, p = .048) and a moderate/dense sTILs density (HR 0.21, 95% CI 0.06-0.75, p = .016) in the primary tumor were significantly associated with decreased risk of progression. TILs density in the lymph node was associated with decreased risk of progression but did not reach statistical significance. The tTILs and sTILs density correlated strongly between the primary tumor and lymph node. Concordance between the pathologists' was moderate (60%-70%).In HPV(+)OPSCC, a higher density of tumoral and stromal TILs in the primary tumor and possibly the lymph node may predict a lower risk of disease progression.© 2023 American Academy of Otolaryngology-Head and Neck Surgery Foundation.