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
TIL（肿瘤浸润淋巴细胞）评分改善 II 期黑色素瘤进展风险预测：一项回顾性队列研究
英文原题：Tumor-infiltrating lymphocyte scoring improves progression risk prediction in stage II melanoma: A retrospective cohort study.
查看英文原题
Tumor-infiltrating lymphocyte scoring improves progression risk prediction in stage II melanoma: A retrospective cohort study.
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研究概要
美国癌症联合委员会第八版亚分期难以预测 II 期黑色素瘤的进展。
中文摘要
背景
美国癌症联合委员会第 8 版亚分期可能不足以预测黑色素瘤进展。若据此选择 II 期患者接受辅助免疫治疗，可能导致对低危 IIB/IIC 期患者治疗过度，而高危 IIA 期患者治疗不足。TIL 对 II 期黑色素瘤的预后预测能力尚不明确。
目的
评估美国癌症联合委员会第 8 版亚分期和 TIL 评分预测 II 期黑色素瘤进展的能力。
方法
开展回顾性队列研究，纳入英国 4 家医院 366 例前哨淋巴结阴性的 II 期黑色素瘤患者（2004–2017 年），并进行长期随访。
结果
中位随访 9.5 年期间，23% 的黑色素瘤出现进展。在这些进展病例中，41.5% 为 IIA 期、41.5% 为 IIB 期、17.1% 为 IIC 期。TIL 评分可独立预测进展风险（旺盛与非旺盛相比：比值比 0.298，P = 0.009；缺失与非旺盛相比：比值比 0.436，P = 0.049），也可预测无进展生存期。非旺盛 TIL 见于 80% 的进展肿瘤，代表高风险。TIL 评分可在各亚分期内区分高低风险患者：具有非旺盛 TIL 的 IIA 期患者，其 5 年无进展生存期与具有缺失/旺盛 TIL 的 IIB/IIC 期患者相近。局限：回顾性研究设计，且结果的普遍适用性未知。
结论
美国癌症联合委员会第 8 版亚分期对 II 期黑色素瘤进展的预测能力有限。TIL 评分可改善跨亚分期风险分层，并可能成为一种成本效益良好的方法，更准确识别可能从辅助免疫治疗中获益的患者。
展开英文摘要原文
BACKGROUND
The American Joint Committee on Cancer eighth edition substaging might be suboptimal for predicting melanoma progression. Using it to select stage II patients for adjuvant immunotherapy risks overtreating low-risk stage IIB/IIC patients and undertreating high-risk stage IIA patients. Prognostic capability of tumor-infiltrating lymphocytes (TILs) is unclear in stage II melanoma.
OBJECTIVE
To evaluate the American Joint Committee on Cancer eighth edition substaging and TIL scoring as predictors of progression in stage II melanoma.
METHODS
Retrospective cohort study of 366 sentinel lymph node negative stage II melanoma patients from 4 UK hospitals (2004-2017), with long-term follow-up.
RESULTS
Twenty-three percent of melanomas progressed (median 9.5-year follow-up). Among those, 41.5% were stage IIA, 41.5% IIB, and 17.1% IIC. TIL scoring independently predicted progression risk (brisk vs non-brisk: odds ratio: 0.298, P = .009; absent vs non-brisk: odds ratio: 0.436, P = .049) and progression-free survival. Nonbrisk TILs, present in 80% of progressing tumors, denoted high risk. TIL scoring split patients into high and low risk across substages: stage IIA patients with non-brisk TILs had similar 5-year progression-free survival to stage IIB/IIC patients with absent/brisk TILs. LIMITATIONS: Retrospective study design and unknown generalizability.
CONCLUSION
Stage II melanoma progression is poorly predicted by the American Joint Committee on Cancer eighth edition substage. TIL scoring offers improved risk stratification across substages and could serve as a cost-effective method to better identify patients who may benefit from adjuvant immunotherapies.
论文信息
- 作者
- Adigbli G、Reed B、Khera B、Sangha M、Thadani S、Wilder-Smith AB、Wojtowicz M、Pissaridou M
- 单位
- Translational Research Immunology Group, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Nuffield Department of Surgical Sciences, University of Oxford, Oxford, United Kingdom; Department of Plastic Surgery, The Churchill Hospital, Oxford University Hospitals NHS Trust, Oxford, United Kingdom; Stoke Mandeville Hospital, Buckinghamshire Healthcare NHS Trust, Aylesbury, United Kingdom. Electronic address: george.adigbli@nds.ox.ac.uk.United Kingdom
- 文献类型
- 多中心研究 · 非美国政府资助研究
- 期刊
- Journal of the American Academy of Dermatology2025 Jul
- 原文标识
- PubMed 40122211 · DOI 10.1016/j.jaad.2025.03.046