研究概要
HEV是切除GC中RFS和OS最重要的免疫预后因素,提示炎症性TME。
研究思路结论见上方概要
背景
高内皮微静脉(HEV)是淋巴细胞运输的特化血管系统。虽然 HEV 在胃癌(GC)中经常被观察到,但 HEV 与TIL(肿瘤浸润淋巴细胞)(TILs)之间的血管-免疫相互作用尚未得到充分阐明。在本研究中,我们旨在利用大量前瞻性收集的 GC 手术标本,揭示 HEV 作为 GC 中 T 细胞炎症免疫微环境替代标志物的潜在价值。
方法
我们纳入了460例接受手术切除的GC患者。采用Nanostring PanCancer免疫谱分析评估GC的免疫表型。分析了HEV密度和三种不同的TIL模式(克罗恩样淋巴反应、瘤周淋巴反应和瘤内淋巴反应)之间的关系,并将其作为无复发生存期(RFS)和总生存期(OS)的预后因素进行评估。
结果
HEV-high GC显示免疫细胞亚群浸润增加,包括树突状细胞、CD8+细胞毒性T细胞和CD4+辅助性T细胞。此外,HEV-high GC显示免疫调节趋化因子、I型或II型干扰素通路和免疫检查点增加,所有这些都表明存在炎症性肿瘤微环境(TME)。三种不同模式的TIL均与HEV密度相关。在生存分析中,HEV-high GC患者的RFS和OS显著长于HEV-low GC患者(RFS的p<0.001,OS的p<0.001)。多变量分析表明,在调整年龄、分期和TIL后,HEV是RFS(高HEV患者与低HEV患者相比;HR 0.412,95% CI 0.241至0.705,p=0.001)和OS(HR 0.547,95% CI 0.329至0.909,p=0.02)最显著的免疫预后因素。
展开英文摘要原文
BACKGROUND: High endothelial venule (HEV) is a specialized vasculature for lymphocyte trafficking. While HEVs are frequently observed within gastric cancer (GC), the vascular-immune interaction between HEV and tumor-infiltrating lymphocytes (TILs) has not been well elucidated. In this study, we aimed to unveil the potential value of HEVs as a surrogate marker for T-cell inflamed immune microenvironment in GC using a large number of prospectively collected surgical specimens of GC.
METHODS: We included 460 patients with GC who underwent surgical resection. Nanostring PanCancer immune profiling was performed to evaluate the immunological phenotype of GCs. HEV density and three distinct patterns of TILs (Crohn-like lymphoid reaction, peritumoral lymphoid reaction, and intratumoral lymphoid reaction) were analyzed for their relationship and evaluated as prognostic factors for relapse-free survival (RFS) and overall survival (OS).
RESULTS: HEV-high GC revealed increased infiltration by immune cell subsets, including dendritic cells, CD8 + cytotoxic T cells, and CD4 + helper T cells. In addition, HEV-high GC demonstrated increased immune-modulating chemokines, type I or II interferon pathway, and immune checkpoints, all of which indicate the inflamed tumor microenvironment (TME). All three distinct patterns of TILs were associated with HEV density. In survival analysis, patients with HEV-high GC displayed significantly longer RFS and OS than those with HEV-low GC (p<0.001 for RFS, p<0.001 for OS). Multivariate analysis demonstrated that HEV was the most significant immunological prognostic factor for RFS (patients with high HEV compared with those with low HEV; HR 0.412, 95% CI 0.241 to 0.705, p=0.001) and OS (HR 0.547, 95% CI 0.329 to 0.909, p=0.02) after adjustment for age, stage, and TIL.
CONCLUSION: HEV is the most significant immunological prognosticator for RFS and OS in resected GC, indicating inflamed TME.
论文信息
- 作者
- Park HS、Kim YM、Kim S、Lee WS、Kong SJ、Yang H、Kang B、Cheon J
- 第一作者单位
- Division of Medical Oncology, Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea (the Republic of).South Korea
- 通讯作者单位
- Medical Oncology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Gyeonggi-do, Korea (the Republic of) minidoctor@cha.ac.kr chan@cha.ac.kr.South Korea
- 文献类型
- 非美国政府资助研究
- 期刊
- Journal for immunotherapy of cancer2021 Oct