# Associations Between Body Composition and Intratumoural Immune Cells in Patients With Uterine Cervical Cancer

## TL;DR

This study explores how body composition factors like muscle and fat are linked to immune cell presence in cervical cancer patients, suggesting these factors could predict outcomes.

## Contribution

The study identifies novel associations between specific body composition parameters and immune cell infiltration in uterine cervical cancer.

## Key findings

- Low muscle radiodensity (myosteatosis) is linked to fewer stromal CD45-positive immune cells.
- High subcutaneous adipose tissue (SAT) correlates with lower tumor-infiltrating CD45 cells.
- Increased intramuscular adipose tissue radiodensity is associated with reduced stromal immune cell infiltration.

## Abstract

In uterine cervical cancer (UCC), reduced muscle mass and radiodensity have been linked to unfavourable clinical outcomes. Our aim was to elucidate the associations between body composition (BC) and intratumoural immune cells in patients with UCC.

In this retrospective study, BC was analysed in 61 patients with UCC using staging computed tomography. The parameters of BC were skeletal muscle area (SMA), skeletal muscle radiodensity, visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT) and intramuscular adipose tissue (IMAT). The radiodensities of VAT, SAT and IMAT were also estimated. Tumour specimens underwent histopathological analysis to quantify stromal and intratumoural CD45‐positive cells. Associations between body composition parameters and tumour immune cell infiltration were analysed using ANOVA.

Patients with low muscle radiodensity (myosteatosis) had a lower proportion of stromal CD45‐positive cells than patients with normal muscle radiodensity (21.6% ± 21.90% vs. 34.85% ± 25.55%; p = 0.04). High levels of SAT were associated with lower scores for tumour‐infiltrating CD45 cells (p = 0.03). High IMAT radiodensity was associated with lower stromal CD45 scores (p = 0.02).

Myosteatosis, high SAT and increased IMAT radiodensity were associated with reduced stromal and intratumoural immune cell infiltration in patients with UCC. These body composition parameters may serve as prognostic markers and should be explored in risk stratification.