Fig. 1
Increase immune cell infiltration is associated with rapid progression of vestibular schwannoma (VS). A Kaplan–Meier analysis showed that the time to recurrence for VS patients with early recurrence (n = 8; red line) was significantly shorter than that for patients with late recurrence (n = 9; blue line; P < 0.0001, log-rank test). B Axial T1-weighted, postcontrast magnetic resonance imaging at the level of the cerebellopontine angle demonstrates the pre-, early post-, and late postoperative statuses of a patient with stable VS (top row) and a patient with rapidly progressing VS (bottom row). C Representative multiplex immunofluorescence imaging of immune markers (CD1A, CD4, CD8, CD20, and CD68) and tumor markers (neural cell adhesion molecule/CD56) in VS samples from patients with early recurrence (top row) and late recurrence (bottom row). D Distributions of cells positive for CD4 (green), CD8 (blue), CD20 (red), CD68 (orange), and CD1A (yellow) among patients with early (E) and late (L) progression. Cell density was calculated as the number of cells per square millimeter and was log2-transformed for representation. Compared with samples from patients with late recurrence, those from patients with early recurrence had significantly higher densities of cells positive for CD4 (67.1 ± 571 vs. 32.9 ± 395.8 cells/mm2), CD8 (50.9 ± 148.1 vs. 9.54 ± 31.7 cells/mm2), CD20 (8.16 ± 112.1 vs. 0.81 ± 4.64 cells/mm2), and CD68 (384.8 ± 563.0 vs. 90.8 ± 206.8 cells/mm2) but a significantly lower density of cells positive for CD1A (60.7 ± 99.5 vs. 186.9 ± 526 cells/mm.2; P < 0.001 for all, Wilcoxon test)