TIL（肿瘤浸润淋巴细胞）在接受根治性放疗/放化疗的头颈部鳞癌患者中的预后与预测价值

Microenvironmental conditions control the entrance and thriving of cytotoxic lymphocytes in tumors, allowing or preventing immune-mediated cancer cell death.

We investigated the role of tumor-infiltrating lymphocyte (TIL) density in the outcome of radiotherapy in a series of squamous cell head neck tumors (HNSCC).

Moreover, we assessed the link between markers of hypoxia and TIL density. One-hundred twenty-one patients with HNSCC treated prospectively with radical radiotherapy/chemo-radiotherapy were analyzed. The assessment of TIL density was performed on hematoxylin and eosin biopsy sections before radiotherapy. TIL density ranged from 0. 8 to 150 lymphocytes per 40 optical field (median 27. 5). Using the median value, patients were grouped into two categories of low and high TIL density. Early T-stage tumors had a significantly higher TIL density (p < 0. 003), but we found no association with N-stage.

Overexpression of HIF1 , HIF2 , and CA9 was significantly linked with poor infiltration by TILs (p < 0. 03). A significant association of high TIL density with better disease-specific overall survival and improved locoregional relapse-free survival was noted (p = 0. 008 and 0. 02, respectively), which was also confirmed in multivariate analysis.

It is concluded that HNSCC phenotypes that allow for the intratumoral accumulation of lymphocytes have a better outcome following radical radiotherapy/chemo-radiotherapy. Intratumoral-activated HIF- and CA9-related pathways characterize immunologically cold tumors and may be used as targets for therapeutic interventions.