免疫检查点阻断通过扩增效应 CD8⁺ T 细胞克隆增强淋巴细胞清除性化疗诱导的抗肿瘤免疫
Immune Checkpoint Blockade Augments Lymphodepleting Chemotherapy-Induced Antitumor Immunity by Expanding Effector CD8+ T-cell Clones.
CELL INTELLIGENCE · 肿瘤细胞治疗研究
肿瘤细胞治疗研究
核分裂计数能否改善黑色素瘤患者的个体化预后？
英文原题：Could the mitotic count improve personalized prognosis in melanoma patients?
查看英文原题
Could the mitotic count improve personalized prognosis in melanoma patients?
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中文摘要
多项研究提示，有丝分裂率可能是黑色素瘤患者预后不良的预测因素。本研究旨在调查有丝分裂率是否与其他临床和病理预后特征相关。在校正其他病理特征后，我们进一步验证有丝分裂数量的预后价值，并确定该变量在哪个人群亚组中对3年死亡风险具有更强预后意义。分析的临床数据来自威尼托癌症登记处（RTV），这是一个覆盖约490万地区居民的高分辨率人群数据库。纳入标准为RTV于2015年（1,050例）和2017年（1,205例）登记且有丝分裂数量可得的所有新发浸润性皮肤恶性黑色素瘤病例。采用Kaplan-Meier曲线分析不同有丝分裂分级的短期总生存期，并通过Cox回归多变量模型评估不同有丝分裂率界值的独立预后作用。
结果表明，有丝分裂率与其他生存预后因素相关，包括TNM分期组成因素（如肿瘤厚度、溃疡、淋巴结状态及转移）以及TNM分期未涵盖的特征（如年龄、肿瘤部位、形态类型、生长模式和TIL）。
此外，即使校正这些预后因素，每平方毫米有丝分裂数仍与死亡率较高相关，尤其是在T2患者中。总之，结果提示组织学诊断应纳入有丝分裂率，因为它作为独立因素与预后相关。有丝分裂率可用于制定黑色素瘤患者治疗和随访监测的个体化医疗方案。
展开英文摘要原文
A number of studies have indicated that the mitotic rate may be a predictive factor for poor prognosis in melanoma patients. The aim of this study was to investigate whether the mitotic rate is associated with other prognostic clinical and anatomopathological characteristics. After adjusting for other anatomopathological characteristics, we then verified the prognostic value of the number of mitoses, determining in which population subgroup this variable may have greater prognostic significance on 3-year mortality. The Veneto Cancer Registry (Registro Tumori del Veneto-RTV), a high-resolution population-based dataset covering the regional population of approximately 4. 9 million residents, served as the clinical data source for the analysis.
Inclusion criteria included all incident cases of invasive cutaneous malignant melanoma recorded in the RTV in 2015 (1,050 cases) and 2017 (1,205 cases) for which the number of mitoses was available. Mitotic classes were represented by Kaplan-Meier curves for short-term overall survival. Cox regression calculated hazard ratios in multivariable models to evaluate the independent prognostic role of different mitotic rate cut-offs.
The results indicate that the mitotic rate is associated with other survival prognostic factors: the variables comprising the TNM stage (e. g. , tumor thickness, ulceration, lymph node status and presence of metastasis) and the characteristics that are not included in the TNM stage (e. g. , age, site of tumor, type of morphology, growth pattern and TIL).
Moreover, this study demonstrated that, even after adjusting for these prognostic factors, mitoses per mm2 are associated with higher mortality, particularly in T2 patients.
In conclusion, these findings revealed the need to include the mitotic rate in the histological diagnosis because it correlates with the prognosis as an independent factor. The mitotic rate can be used to develop a personalized medicine approach in the treatment and follow-up monitoring of melanoma patients.
论文信息
- 作者
- Buja A、Rugge M、Cozzolino C、Dossi F、Zorzi M、Vecchiato A、de Luca G、Del Fiore P
- 第一作者单位
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy.Italy
- 通讯作者单位
- Soft-Tissue, Peritoneum and Melanoma Surgical Oncology Unit, Veneto Institute of Oncology IOV- IRCCS, Padova, Italy.Italy
- 期刊
- PloS one2024
- 原文标识
- PubMed 38626072 · DOI 10.1371/journal.pone.0302309
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