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新辅助 DCF 治疗后接受食管切除术患者的 TIL(肿瘤浸润淋巴细胞)

英文原题:Tumor-infiltrating lymphocytes in patients undergoing esophagectomy following neoadjuvant DCF therapy.

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Tumor-infiltrating lymphocytes in patients undergoing esophagectomy following neoadjuvant DCF therapy.

PubMed 2023/11/30(内容时间) J Surg Oncol Q2 · IF 1.9(JCR 2025)

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研究概要

低 TI CD8+ 细胞水平是接受新辅助 DCF 治疗后行食管切除术的 ESCC 患者的一个显著预后因素。

研究思路结论见上方概要

越来越多的证据表明,肿瘤浸润(TI)细胞的表达水平可能在接受食管切除术的食管癌患者中发挥预后作用。然而,其对新辅助多西他赛、顺铂和5-氟尿嘧啶(DCF)治疗后接受食管切除术的食管鳞状细胞癌(ESCC)患者的影响仍不清楚。因此,本研究旨在阐明接受新辅助DCF治疗后行食管切除术的患者中TI细胞的预后影响。

总体而言,共纳入81例接受新辅助DCF治疗后行根治性食管切除术的ESCC患者。在肿瘤浸润边缘使用光学显微镜在×400倍下测定TI CD8+细胞数量。采用受试者工作特征曲线确定连续变量对死亡率的截断值;将患者分为TI CD8+细胞高组和低组,并比较其背景和临床结局。

TI CD8+低水平组的总生存率和无复发生存率均显著低于TI CD8+高水平组(p < 0.01)。多因素分析显示,ypN阳性(风险比[HR],3.12;95%置信区间[CI],1.08-9.02)和TI CD8+细胞水平低(HR,2.77;95% CI,1.31-5.85)是总生存率的独立预后因素。此外,静脉侵犯阳性(HR,2.63;95% CI,1.29-5.35)和TI CD8+细胞水平低(HR,2.77;95% CI,1.70-5.46)是无复发生存率的显著预后因素。

展开英文摘要原文

Accumulating evidence suggests that expression levels of tumor-infiltrating (TI) cells may play a prognostic role in patients with esophageal cancer who have undergone esophagectomy. However, its effect on patients undergoing neoadjuvant docetaxel, cisplatin, and 5-fluorouracil (DCF) therapy followed by esophagectomy for esophageal squamous cell carcinoma (ESCC) remains unclear. Therefore, this study aimed to elucidate the prognostic impact of TI cells in patients who underwent esophagectomy following neoadjuvant DCF therapy.

Overall, 81 patients with ESCC who underwent curative esophagectomy following neoadjuvant DCF therapy were included. The number of TI CD8+ cells was determined using light microscopy at ×400 in tumor invasive margins. Receiver operative characteristic curve was used to determine the cutoff values for mortality for continuous variables; the patients were separated into high and low TI CD8+ cell groups and their backgrounds and clinical outcomes were compared.

Overall and relapse-free survival were significantly worse in the TI CD8+-low group than that in the TI CD8+-high group (p < 0.01). Multivariate analysis revealed that positive ypN (hazard ratio [HR], 3.12; 95% confidence interval [CI], 1.08-9.02) and low TI CD8+ cell levels (HR, 2.77; 95% CI, 1.31-5.85) were independent prognostic factors for overall survival. Furthermore, positive venous invasion (HR, 2.63; 95% CI, 1.29-5.35) and low TI CD8+ cell levels (HR, 2.77; 95% CI, 1.70-5.46) were significant prognostic factors for relapse-free survival.

Low TI CD8+ cell level was a prominent prognostic factor for patients with ESCC undergoing neoadjuvant DCF therapy followed by esophagectomy.

论文信息

作者
Takahashi K、Sakashita Y、Murahashi M、Kubota H、Shimoda M、Ishikawa Y、Tanishima Y、Kurogochi T
单位
Department of Gastrointestinal Surgery, Jikei University School of Medicine, Tokyo, Japan.Japan
期刊
Journal of surgical oncology2024 Mar
原文标识
PubMed 38031881 · DOI 10.1002/jso.27542