肿瘤细胞治疗研究
英文原题：Analysis of Tumor Microenvironmental Features Between Primary and Synchronous Liver Metastases From Patients With Colorectal Cancers Using a Deep Learning Algorithm.
与原发性相比，同步性CRLMs显示出更高的TSR以及增加的高级别肿瘤和坏死，这些是肿瘤侵袭性和转移表型的特征。
结直肠肝转移（CRLMs）的发生与不良预后相关，近期数据提示肝转移与免疫治疗耐药有关。我们使用一种经过验证的分割算法（QuantCRC），对原发性结直肠癌（CRCs）及其同时性CRLMs的微环境进行了特征分析，该算法可量化15种不同的肿瘤形态学特征。
在Mayo Clinic，通过电子健康记录识别出57例伴有同时性CRLM的成人CRC患者（N = 57）。对常规肿瘤苏木精-伊红切片进行数字化处理并进行质量控制审查。将QuantCRC（Aiforia, Inc）应用于数字化图像，以提取15个GI病理学家预定义的形态学特征。使用Wilcoxon符号秩检验在总体及亚组内比较配对原发肿瘤与其同时性CRLM之间的肿瘤特征。使用线性回归模型寻找不同肿瘤形态学特征配对差异的预测因子。
该研究纳入57例原发性CRC伴同时性CRLM患者（中位年龄59岁[IQR，50-73]，51%为女性），其中37例（65%）原发灶位于左侧。QuantCRC识别出15个形态学特征中有6个在原发灶与其CRLM之间存在显著差异。与原发灶相比，CRLM表现为间质减少、高级别肿瘤和坏死增多、肿瘤-间质比（TSR）更高（所有P < .05），并呈TIL（肿瘤浸润淋巴细胞）密度增加的趋势（P = .052）。左侧原发肿瘤患者的同时性CRLM与原发灶相比，TSR、高级别百分比、坏死百分比和TIL密度均显著更高（所有P值0.04）。在右侧原发灶中，CRLM的成熟间质百分比显著降低（P = .0296），坏死百分比更高（P = .0027）。
PURPOSE: The development of colorectal liver metastases (CRLMs) is associated with poor prognosis, and recent data suggest that metastasis to the liver is associated with resistance to immunotherapy. We characterized the microenvironment of primary colorectal carcinomas (CRCs) relative to their synchronous CRLMs using a validated segmentation algorithm (QuantCRC) that quantifies 15 distinct morphologic tumor features. MATERIALS AND METHODS: Adult patients with CRC with synchronous CRLM (N = 57) at Mayo Clinic were identified from the electronic health record. Routine tumor hematoxylin and eosin sections were digitized and reviewed for quality control. QuantCRC (Aiforia, Inc) was applied to digitized images to extract 15 GI pathologist predefined morphological features. Tumor features were compared between paired primary tumors and their synchronous CRLMs using the Wilcoxon signed-rank test overall and within subgroups. Linear regression models were used to find predictors of the paired differences in the distinct tumor morphological features. RESULTS: The study included 57 patients (median age 59 years [IQR, 50-73], 51% female) with CRC primary and synchronous CRLM, and among primaries, 37 (65%) were left-sided. QuantCRC identified six of 15 morphological features that differed significantly between primaries and their CRLMs. Compared with the primary, CRLM showed reduced stroma, more high-grade tumor and necrosis, higher tumor-stromal ratio (TSR; all P < .05), and a trend toward increased tumor-infiltrating lymphocyte (TIL) density ( P = .052). Synchronous CRLM from patients with left-sided primary tumors had significantly higher TSR, percent high-grade, percent necrosis, and TIL density compared with the primary (all P values 0.04). Among right-sided primaries, CRLM had a significantly reduced percent mature stroma ( P = .0296) and a higher percent necrosis ( P = .0027). CONCLUSION: Compared with the primary, synchronous CRLMs showed a higher TSR and increased high-grade tumor and necrosis, which are features of tumor aggressiveness and a metastatic phenotype.
MEMBER ACCOUNT
登录成功会直接打开下一页。
