再分化使能的 TSHRCART 细胞克服侵袭性甲状腺癌中的抗原丢失
Redifferentiation-enabled TSHRCART cells overcome antigen loss in aggressive thyroid cancers.
这些发现确立了肿瘤再分化作为一种可推广的策略,用于克服抗原丢失并增强CART细胞疗法在甲状腺癌以及可能其他实体瘤中的疗效。
英文原题:Characterization of Immune Infiltrate Along the Leading Edge of Differentiated Thyroid Cancer.
Characterization of Immune Infiltrate Along the Leading Edge of Differentiated Thyroid Cancer.
结果:与邻近甲状腺组织相比,免疫检查点 PD-1 和 PD-L1 在肿瘤内的表达显著增加(p < 0.05)。
背景:尽管已有报道指出肿瘤免疫浸润对分化型甲状腺癌(DTC)行为的影响,但仅检测免疫检查点[程序性细胞死亡蛋白1(PD-1)及其配体(PD-L1)]的表达尚无法预测免疫治疗的应答。我们旨在鉴定与DTC相关的肿瘤浸润免疫细胞及检查点。方法:我们对17例DTC成人患者甲状腺切除术中采集的石蜡包埋甲状腺组织进行多重免疫荧光染色,以表征肿瘤免疫微环境中的白细胞(CD45+)、T细胞(CD3+)、调节性T细胞(Tregs)(CD3+FOXP3+)、CD4+ T细胞(CD3+CD4+)、CD8+ T细胞(CD3+CD8+)、巨噬细胞(CD68+)、M2型巨噬细胞(CD68+CD163+)、M1型巨噬细胞(CD68+诱导型一氧化氮合酶[iNOS]+)以及免疫检查点PD-1和PD-L1。我们采用配对t检验比较同一患者肿瘤与癌旁甲状腺组织中免疫标志物平均表达百分比的差异,并沿肿瘤前沿进行空间分析。结果:与癌旁甲状腺组织相比,免疫检查点PD-1和PD-L1在瘤内表达显著升高(p < 0.05)。与癌旁组织相比,瘤内M2型巨噬细胞呈较高趋势。沿肿瘤前沿,瘤内PD-L1表达与CD45呈负相关,与CD163呈正相关。在探索性分析中,伴有远处转移的DTC(n = 3)与不伴远处转移者(n = 14)相比,肿瘤中FOXP3表达较高而CD8和iNOS表达较低,但差异无统计学意义。伴有甲状腺炎(n = 7)与不伴甲状腺炎(n = 10)的DTC相比,CD58和iNOS表达较高,但差异无统计学意义。结论:肿瘤内较高的PD-1和PD-L1表达提示其在DTC发生中的作用。在远处转移性DTC患者中,肿瘤内Tregs和M2巨噬细胞增多而M1巨噬细胞减少的趋势,提示它们作为预后生物标志物的潜在作用。未来需要更大样本量的研究来比较各种临床病理严重程度,以利用肿瘤微环境进行癌症预后判断和治疗。
Background : Although the impact of tumor-immune infiltrate has been reported on differentiated thyroid cancer (DTC) behavior, the expression of immune checkpoints [programmed cell death protein 1 (PD-1) and its ligand (PD-L1)] alone has not been able to predict response to immunotherapies. We aimed to identify tumor-infiltrating immune cells and checkpoints associated with DTC. Methods : We performed multiplex immunofluorescence on deparaffinized thyroid tissue collected at thyroidectomy from 17 adults with DTC to characterize the tumor immune microenvironment for leukocytes (CD45+), T cells (CD3+), T regulatory cells (Tregs) (CD3+FOXP3+), CD4 + T cells (CD3+CD4 + ), CD8+ T cells (CD3+CD8+), macrophages (CD68+), M2 macrophages (CD68+CD163+), M1 Macrophages (CD68+ inducible nitric oxide synthase [iNOS]+), and immune checkpoints PD-1 and PD-L1. We compared the mean percentage expression of immune markers between tumor and adjacent thyroid tissue from the same patient by paired t -test and performed spatial analysis along the tumor's leading edge. Results : Immune checkpoints PD-1 and PD-L1 showed a significant increase in expression intratumorally as compared to adjacent thyroid tissue ( p < 0.05). A higher trend for M2 macrophages was observed intratumorally compared to adjacent tissue. Along the leading edge, PD-L1 expression correlated negatively with CD45 and positively with CD163 intratumorally. On exploratory analysis, there was a nonsignificant trend for higher FOXP3 but less CD8 and iNOS expression in tumor from DTC with ( n = 3) versus without distant metastases ( n = 14). There was a nonsignificant trend for higher CD58 and iNOS expression in DTC with ( n = 7) than without thyroiditis ( n = 10). Conclusions : Higher tumoral PD-1 and PD-L1 expression indicate their role in DTC occurrence. A trend for more Tregs and M2 macrophages but less M1 macrophages intratumorally in patients with distant metastatic DTC, suggests their potential role as prognostic biomarkers. Future studies with larger sample sizes are needed to compare various clinicopathologic severities to harness tumor microenvironment for cancer prognostication and therapy.
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