非常规 T 细胞在泌尿系统肿瘤中：能抓住就抓住
Unconventional T cells in urological cancers: catch them if you can.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
改良免疫评分改善非肌层浸润性膀胱癌患者无进展生存期的预测：一项数字病理学研究
英文原题：Modified immunoscore improves the prediction of progression-free survival in patients with non-muscle-invasive bladder cancer: A digital pathology study.
查看英文原题
Modified immunoscore improves the prediction of progression-free survival in patients with non-muscle-invasive bladder cancer: A digital pathology study.
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中文摘要
TIL（肿瘤浸润淋巴细胞）已知在多种实体瘤中具有预后价值，近年来一直是研究热点。TIL通常通过IMMUNOSCORE（IS）进行量化，这是一种基于TIL细胞密度的评分系统。近期研究已能够在肌层浸润性膀胱癌（MIBC）中重复这些发现，然而关于非肌层浸润性膀胱癌（NMIBC）的数据仍然匮乏。
本研究旨在利用组织微阵列（TMA）评估改良Immunoscore（mIS）作为NMIBC预后预测标志物的价值。我们分析了两个TMA，包含来自158例NMIBC患者的316份样本，进行了CD3、CD8、CD45RO和FOXP3染色。染色后的TIL通过数字病理学捕获，进行累积、取平均值，并以密度（每mm²染色细胞数）报告。随后基于所有四种免疫细胞类型的密度构建mIS。回顾性收集临床、病理及随访数据。进行单因素和多因素Cox回归分析，以评估mIS作为无进展生存期（PFS）和无复发生存期（RFS）预测因子的潜在价值。将“欧洲癌症研究与治疗组织”（EORTC）风险组内的患者进一步分为高mIS和低mIS亚组。
最后使用log-rank检验比较不同生存曲线。我们队列的中位年龄为68岁（四分位距（IQR）：60 - 76），117例（74%）患者为男性。共有26例患者（16.5%）被归类为EORTC低风险，45例（28.5%）为中风险，87例（55.1%）为高风险。EORTC高风险组中低mIS的患者与高mIS相比显示出更短的PFS（HR 2.9，CI 0.79 - 11.0，p=0.082）。相比之下，在中危或低危组中未观察到关于 PFS 的预测潜力。
此外，mIS 无法预测任何 EORTC 风险组中的 RFS。通过识别进展风险较高或较低的患者，mIS 可用于更准确地预测高危 NMIBC 患者的预后。
因此，mIS 可用于将这些高危患者分配至更简化的随访或更积极的治疗策略。
展开英文摘要原文
Tumour-infiltrating lymphocytes (TIL), known to be of prognostic value in various solid tumours, have been in the focus of research in the last years. TIL are often quantified via IMMUNOSCORE (IS), a scoring system based on TIL cell densities. Recent studies were able to replicate these findings for muscle-invasive bladder cancer (MIBC), however data regarding non-muscle-invasive bladder cancer (NMIBC) are scarce.
This study aimed to evaluate the value of a modified Immunoscore (mIS) as a predictive marker for NMIBC prognosis using tissue-micro-arrays (TMAs).
We analysed two TMAs containing 316 samples from 158 patients with NMIBC, stained for CD3, CD8, CD45RO and FOXP3. Stained TIL were captured by digital pathology, cumulated, averaged, and reported as density (stained cells per mm ). The mIS was then constructed based on density of all four immune-cell types. Clinical, pathological and follow-up data were collected retrospectively.
Univariable and multivariable cox regression analysis was performed to assess the potential value of mIS as a predictor for progression free survival (PFS) and recurrence-free-survival (RFS). Patients within "European Organisation for Research and Treatment of Cancer" (EORTC) risk groups were further substratified in high mIS and low mIS subgroups.
Finally log-rank test was used to compare the different survival curves. The median age in our cohort was 68 years (Interquartile Range (IQR): 60 - 76), and 117 (74%) patients were male. A total of 26 patients (16. 5%) were classified as EORTC low risk, 45 (28. 5%) as intermediate risk and 87 (55. 1%) as high risk. Patients in the EORTC high risk group with low mIS showed a shorter PFS in comparison to high mIS (HR 2. 9, CI 0. 79 - 11. 0, p=0. 082). In contrast, no predictive potential regarding PFS was observed in intermediate or low risk groups.
Furthermore, mIS was not able to predict RFS in any EORTC risk group. mIS could be utilized to predict prognosis more accurately in high-risk patients with NMIBC by identifying those with higher or lower risk of progression.
Therefore, mIS could be used to allocate these highrisk patients to more streamlined follow-up or more aggressive treatment strategies.
论文信息
- 作者
- Bieri U、Enderlin D、Buser L、Wettstein MS、Eberli D、Moch H、Hermanns T、Poyet C
- 单位
- Department of Urology, University Hospital of Zurich, University of Zurich, Zurich, Switzerland.Switzerland
- 期刊
- Frontiers in oncology2022
- 原文标识
- PubMed 36212478 · DOI 10.3389/fonc.2022.964672
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