For immune cell profiling we conducted mfIHC. Details of the procedure have been described previously [28 (link)]. Tyramide signal amplification was used employing an Opal IHC kit (PerkinElmer, Waltham, MA) according to the manufacturer's instructions. We previously constructed a T-cell panel, comprising CD3, CD4, CD8, FOXP3 and T-bet. This panel also included cytokeratin to differentiate tumor and stromal areas, and DAPI for staining nuclei [28 (link)]. Primary antibodies used were: CD3 (clone SP7, Abcam, Tokyo, Japan), CD4 (clone 4B12, Leica Microsystems, Tokyo, Japan), CD8 (clone 4B11, Leica Microsystems), FOXP3 (D6O8R, Cell Signaling Technology, Danvers, MA), T-bet (clone 4B10, Santa Cruz Biotechnology, Dallas, CA) and cytokeratin (clone AE1/AE3, Dako Agilent Technologies, Santa Clara, CA). Employing an automated imaging system (Vectra ver. 3.0, PerkinElmer), an average of 20 areas at × 200 were captured for each patient. An image analyzing software program (InForm, PerkinElmer) segmented cancer tissue into cancer cell nests (intratumoral) and the framework (stromal) region, and detected immune cells with specific phenotypes. Representative images of tissue segmentation and cell phenotype recognition are shown in Additional file 2. Infiltrating immune cells were quantified using an analytic software program (Spotfire, TIBCO, Palo Alto, CA) and then calculated per area.
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