CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
英文原题：Tumor Infiltrating Lymphocytes Predict Survival in Solid Organ Transplant Recipients With Monomorphic Post-transplant Lymphoproliferative Disorders.
Tumor Infiltrating Lymphocytes Predict Survival in Solid Organ Transplant Recipients With Monomorphic Post-transplant Lymphoproliferative Disorders.
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肿瘤微环境（TME）和 TIL（肿瘤浸润淋巴细胞）（TILs）在与单一形态型移植后淋巴增殖性疾病（PTLD）的预后相关。
对确诊为单形性 B 细胞 PTLD 患者的存档诊断活检进行 CD3 免疫组化，测定 TIL 密度（CD3⁺ 细胞/mm²）。
在 107 例单形性 PTLD 中，TIL 计数低与较差的 2 年无进展生存期（PFS；41% vs 86%，P=0.003）和总生存期（OS；52% vs 93%，P=0.003）相关。Cox 单变量回归显示，TIL 低显著关联较差 PFS（HR=4.5，95% CI：2.0–9.9，P<0.001）和 OS（HR=4.6，95% CI：1.8–11.8，P<0.001）。纳入临床变量（年龄≥60 岁、LDH 高、III/IV 期、CNS 受累）及 TIL 计数的多变量分析显示，PFS 关联仍显著（HR=3.3，95% CI：1.3–8.3，P=0.010），OS 则呈无统计学意义的趋势（HR=2.6，95% CI：0.9–7.3，P=0.064）。由 TIL 和临床变量（年龄≥60 岁、LDH 高、III/IV 期、CNS 受累）构成的综合评分可有效按 PFS 和 OS 对单形性 PTLD 患者进行风险分层（2 年 OS：低危 93%、中危 61%、高危 23%；P<0.001）。
TME 和 TIL 对单形性 PTLD 具有预后意义。纳入 TME 指标的预后模型可能改善单形性 PTLD 患者风险分层。
TIL density (CD3+ cells/mm 2 ) was determined by CD3 immunohistochemistry in archived diagnostic biopsies from patients diagnosed with monomorphic B-cell PTLD.
Amongst monomorphic PTLDs (N = 107), low TIL-count was associated with inferior 2-year progression-free survival (PFS) (41% versus 86%, P = .003) and 2-year overall survival (OS) (52% versus 93%, P = .003) by Kaplan-Meier analysis. Low TIL-count was significant on Cox univariate regression for inferior PFS (HR 4.5, 95% CI 2.0-9.9, P < .001) and OS (HR 4.6, 95% CI 1.8-11.8, P < .001). Multivariate analysis with clinical variables (age 60 years, high LDH, stage III/IV, CNS involvement) and TIL-count showed significance for PFS (HR 3.3, 95% CI 1.3-8.3, P = .010) and a non-significant trend for OS (HR 2.6, 95% CI 0.9-7.3, P = .064). A composite score including TILs and clinical variables (age 60 years, high LDH, stage III/IV, CNS involvement) effectively stratified monomorphic PTLD patients by PFS and OS (2-year OS: low-risk 93%, intermediate-risk 61%, high-risk 23%, P < .001).
The TME and TILs are prognostically relevant in monomorphic PTLD. Prognostic models including measures of the TME may improve risk stratification for patients with monomorphic PTLDs.
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