纵向血浆代谢组学指导食管鳞状细胞癌化疗免疫治疗的动态风险评估与饮食调节
Longitudinal Plasma Metabolomics Guides Dynamic Risk Assessment and Dietary Modulation for Esophageal Squamous Cell Cancer Chemoimmunotherapy.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
食管神经内分泌肿瘤的临床病理特征、预后及淋巴细胞浸润分析：基于手术队列和倾向性评分匹配研究
英文原题：Analysis of the Clinicopathological Characteristics, Prognosis, and Lymphocyte Infiltration of Esophageal Neuroendocrine Neoplasms: A Surgery-Based Cohort and Propensity-Score Matching Study.
查看英文原题
Analysis of the Clinicopathological Characteristics, Prognosis, and Lymphocyte Infiltration of Esophageal Neuroendocrine Neoplasms: A Surgery-Based Cohort and Propensity-Score Matching Study.
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研究概要
E-NECs 与较差的预后显著相关，但早期疾病除外。与 ESCC 相比，E-NECs 肿瘤微环境内 TILs 较少，导致抗肿瘤免疫力较弱，并可能导致预后较差。
研究思路结论见上方概要
背景
食管神经内分泌肿瘤（E-NENs）是食管癌中一种罕见且报道较少的亚型。我们分析了E-NENs与食管鳞状细胞癌（ESCC）在临床病理特征、预后及TIL（肿瘤浸润淋巴细胞）（TILs）方面的差异。
方法
共回顾性纳入3620例接受食管切除术的患者。通过倾向性评分匹配将研究队列分为两组（E-NENs和ESCC），并比较两组之间的预后和TILs。使用肿瘤标本（包括6例ESCC、6例神经内分泌癌[NECs]和6例混合性神经内分泌-非神经内分泌肿瘤[MiNENs]）评估TILs。
结果
E-NENs 占病例的 3.0%（107/3620），其中仅有 3 例神经内分泌肿瘤、51 例 NEC 和 53 例 MiNENs。匹配后，食管神经内分泌癌（E-NECs）与 ESCC 相比，5 年总生存期（OS；35.4% vs. 54.8%，p = 0.0019）和无复发生存（RFS；29.3% vs. 48.9%，p < 0.001）均更差。然而，在 I 期亚组中差异不显著。E-NECs 接受多模式治疗未观察到显著的生存获益。多因素分析表明，E-NECs 是 OS 和 RFS 的独立危险因素。在探索性分析中，与 ESCC 相比，E-NECs 与免疫细胞浸润较少相关。
展开英文摘要原文
BACKGROUND
Esophageal neuroendocrine neoplasms (E-NENs) are a rare and poorly reported subtype of esophageal carcinoma. We analyzed the differences in clinicopathological features, prognosis, and tumor-infiltrating lymphocytes (TILs) between E-NENs and esophageal squamous cell carcinoma (ESCC).
METHODS
A total of 3620 patients who underwent esophagectomy were enrolled retrospectively. The study cohort was divided into two groups (E-NENs and ESCC) through propensity-score matching, and the prognosis and TILs were compared between the two groups. The TILs were assessed using tumor specimens (including six cases of ESCC, six cases of neuroendocrine carcinomas [NECs], and six cases of mixed neuroendocrine-non-neuroendocrine neoplasms [MiNENs]).
RESULTS
E-NENs accounted for 3.0% (107/3620) of cases, among which there were just 3 neuroendocrine tumor cases, 51 NEC cases, and 53 MiNENs cases. After matching, esophageal neuroendocrine carcinomas (E-NECs) showed both poorer 5-year overall survival (OS; 35.4% vs. 54.8%, p = 0.0019) and recurrence-free survival (RFS; 29.3% vs. 48.9%, p < 0.001) compared with ESCC. However, the differences were not prominent in the subgroup with stage I. No significant survival benefit was observed for E-NECs with multimodal therapy. Multivariate analysis demonstrated that E-NECs are an independent risk factor for OS and RFS. In the exploratory analysis, E-NECs were associated with less infiltration of immune cells compared with ESCC.
CONCLUSION
E-NECs are significantly associated with a poorer prognosis than ESCC except for early-stage disease. The fewer TILs within the tumor microenvironment of E-NECs compared with ESCC results in weaker anti-tumor immunity and may lead to a poorer prognosis.
论文信息
- 作者
- Zhang L、Yu B、Liu Z、Wei J、Pan J、Jiang C、Li Z
- 单位
- Department of Thoracic Surgery, Section of Esophageal Surgery, Shanghai Chest Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.China
- 期刊
- Cancers2023 Mar 13
- 原文标识
- PubMed 36980618 · DOI 10.3390/cancers15061732
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