CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
纳入 p16 与 TIL（肿瘤浸润淋巴细胞）的肛管癌放化疗后预后因素多中心研究
英文原题：Multicentre Investigation of Prognostic Factors Incorporating p16 and Tumour Infiltrating Lymphocytes for Anal Cancer After Chemoradiotherapy.
查看英文原题
Multicentre Investigation of Prognostic Factors Incorporating p16 and Tumour Infiltrating Lymphocytes for Anal Cancer After Chemoradiotherapy.
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研究概要
我们完善了 ASCC 的预后因素。
中文摘要
肛门鳞状细胞癌（ASCC）与人乳头瘤病毒高度相关。标准治疗为剂量一致、缺乏分层的放化疗。p16INK4A（p16）免疫组化染色是人乳头瘤病毒的替代指标，可预测结局。本研究结合包括TIL（肿瘤浸润淋巴细胞）评分在内的临床病理因素进行评估。
采用独立、多中心队列，纳入 257 例接受放化疗的 ASCC 患者；对治疗前活检样本进行 p16 和 TIL 染色及评分。按分期、p16 和 TIL 评分绘制无病生存期（DFS）、总生存期及癌症特异性生存期的 Kaplan-Meier 曲线，并以 log-rank 检验评估预后作用。采用 Cox 回归进行多变量分析。
分期、性别、p16 和 TIL 均为独立预后因素。p16 阴性相较阳性、T3/4 相较 T1/2、男性相较女性，以及 TIL1 相较 TIL3 的死亡（总生存期）风险比分别为 2.51（95% CI 1.36–4.63）、2.17（1.34–3.5）、2.42（1.52–3.8）和 3.30（1.52–7.14；均 P<0.05）。
本研究进一步明确了 ASCC 的预后因素。就早期疾病 DFS 以及局部晚期癌症总生存期/DFS 而言，p16 可在分期基础上增加风险分层信息。数据支持宿主免疫反应参与决定临床结局。这些因素将在 PLATO 研究（ISRCTN88455282）中前瞻性评估。
展开英文摘要原文
Using an independent, multicentre cohort of 257 ASCC treated with chemoradiotherapy, pretreatment biopsies were stained and scored for p16 and TIL. Kaplan-Meier curves were derived for outcomes (disease-free survival [DFS], overall survival and cancer-specific survival), by stage, p16 and TIL scores and Log-rank tests were carried out to investigate prognostic effect. A multivariate analysis was carried out using Cox regression.
Stage, sex, p16 and TILs were independently prognostic. Hazard ratios for death (overall survival) were 2.51 (95% confidence interval 1.36-4.63) for p16 negative versus p16 positive, 2.17 (1.34-3.5) for T3/4 versus T1/2, 2.42 (1.52-3.8) for males versus females and 3.30 (1.52-7.14) for TIL1 versus TIL3 (all P < 0.05).
We have refined prognostic factors in ASCC. p16 adds to stratification by stage with respect to DFS in early disease and overall survival/DFS in locally advanced cancers. Our data support the role of the host immune response in mediating outcomes. These factors will be prospectively evaluated in PLATO (ISRCTN88455282).
论文信息
- 作者
- Wakeham K、Murray L、Muirhead R、Hawkins MA、Sebag-Montefiore D、Brown S、Murphy L、Thomas G
- 第一作者单位
- Sussex Cancer Centre, Royal Sussex County Hospital, Brighton, UK; Institute of Cancer Sciences, University of Glasgow, Glasgow, UK.United Kingdom
- 通讯作者单位
- MRC Clinical Trials Unit at UCL, London, UK. Electronic address: duncan.gilbert2@nhs.net.United Kingdom
- 文献类型
- 多中心研究 · 非美国政府资助研究
- 期刊
- Clinical oncology (Royal College of Radiologists (Great Britain))2021 Oct
- 原文标识
- PubMed 34024700 · DOI 10.1016/j.clon.2021.04.015