TIL（肿瘤浸润淋巴细胞）在恶性腹膜间皮瘤中的临床意义：一项 143 例单中心研究

英文原题：Clinical Significance of Tumor-Infiltrating Lymphocytes in Malignant Peritoneal Mesothelioma: A Single-Center Study of 143 Cases.

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Clinical Significance of Tumor-Infiltrating Lymphocytes in Malignant Peritoneal Mesothelioma: A Single-Center Study of 143 Cases.

PubMed 2025/05/15（内容时间） Ann Surg Oncol Q1 · IF 3.8（JCR 2025）

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间皮瘤地区：中国

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研究概要

TILs 可能是预测恶性胸膜间皮瘤患者预后并指导个体化治疗策略的有用指标。

中文摘要

背景

恶性腹膜间皮瘤（MPM）是一种罕见恶性肿瘤，死亡率高、预后极差。肿瘤免疫微环境，尤其是TIL（肿瘤浸润淋巴细胞），在疾病进展及治疗应答中发挥关键作用。本研究旨在分析TIL水平与MPM主要临床病理特征及预后的相关性。

患者与方法

收集143例MPM患者肿瘤细胞减灭术后的标本，并进行苏木精-伊红（H&E）染色。采用QuPath 0.3.2软件对TIL水平进行定量分析。通过单变量和多变量分析，考察TIL水平与其他常规临床病理特征的关系。

结果

143例MPM患者中，男性73例（51.0%），女性70例（49.0%），年龄中位数为55岁（范围24–73岁）。低TIL和高TIL病例分别为72例（50.3%）和71例（49.7%）。单变量分析显示，低与高TIL水平与以下7项临床病理因素呈负相关：手术史、Ki-67指数、术前CA125水平、腹膜癌指数（PCI）、出血量、红细胞输注量和腹水量（均P<0.05）。多变量分析表明，TIL水平与术前糖类抗原（CA）125水平独立负相关（比值比0.394，95%置信区间0.179–0.866，P=0.020）。Cox回归分析提示，高TIL水平与MPM预后较好独立相关。此外，还评估了一组接受术前化疗联合靶向治疗的患者的疗效。Kaplan-Meier曲线显示，高TIL浸润可预测接受治疗患者总生存期较长。

结论

TIL可作为预测MPM患者预后和指导个体化治疗策略的有用指标。

展开英文摘要原文

BACKGROUND

Malignant peritoneal mesothelioma (MPM) is a rare malignant tumor with high mortality rate and extremely poor prognosis. The tumor immune microenvironment, particularly tumor-infiltrating lymphocytes (TILs), plays a critical role in disease progression and treatment response. This study aimed to analyze the correlation between the level of TILs and the main clinicopathological characteristics and prognosis of MPM.

PATIENTS AND METHODS

A total of 143 postoperative specimens from patients with MPM following cytoreductive surgery were collected. Postoperative specimens were stained with hematoxylin and eosin (H&E). The level of TILs was quantitatively analyzed by QuPath 0.3.2 software. Univariate and multivariate analyses were conducted to investigate the correlation between TILs level and other conventional clinicopathological characteristics.

RESULTS

Among the 143 patients with MPM, 73 were male (51.0%) and 70 were female (49.0%), with a median age of 55 (range 24-73) years. There were 72 (50.3%) cases with low TILs, and 71 (49.7%) cases with high TILs. Univariate analysis showed that TIL level (low versus high) was negatively correlated with the following seven clinicopathological factors: surgery history, Ki-67 index, preoperative CA125 level, peritoneal cancer index (PCI) index, bleeding volume, red blood cell (RBC) transfusion volume, and ascites volume (all P < 0.05). Multivariate analysis indicated that TIL level was independently negatively correlated with preoperative carbohydrate antigen (CA)125 level (odds ratio 0.394, 95% CI 0.179-0.866, P = 0.020). Cox regression analysis suggested that high TILs was independently associated with better prognosis of MPM. Moreover, a cohort of patients who received preoperative chemotherapy combined with targeted therapy were evaluated for response. Kaplan-Meier curve showed that high infiltration of TILs predicted better overall survival in patients undergoing treatment.

CONCLUSIONS

TILs could be a useful indicator for predicting prognosis and guiding personalized treatment strategies in patients with MPM.

论文信息

作者: Wu HL、Yang R、Liang XL、Ma R、Su YD、Yang ZR、Cui YR、Du XM
第一作者单位: Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.China
通讯作者单位: Department of Peritoneal Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Changping District, Beijing, China. liyansd2@163.com.China
期刊: Annals of surgical oncology2025 Jul

原文标识: PubMed 40372588　·　DOI 10.1245/s10434-025-17437-z

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