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HER2 阳性结直肠癌肿瘤免疫微环境特征:与预后和治疗意义的相关性

英文原题:Characterization of the Tumor Immune Microenvironment in HER2-Positive Colorectal Cancer: Association With Prognostic and Therapeutic Implications.

PubMed 2025/08/20(内容时间) Clin Colorectal Cancer Q3 · IF 2.7(JCR 2025)

研究概要

本研究描述了初步的免疫微环境特征,并表明CD68与HER2阳性CRC患者的EFS相关性增加。这些免疫微环境特征及预后意义可作为潜在生物标志物,用于将HER-2阳性患者分层以纳入临床试验。

研究思路结论见上方概要

人表皮生长因子受体2(HER2)状态已被提出作为生物标志物,用于识别适合接受抗HER2治疗的大肠癌(CRC)患者。然而,HER2阳性CRC患者的治疗反应因肿瘤免疫微环境(TIME)等因素的影响而存在差异,与HER2阴性CRC不同。我们旨在通过评估炎症细胞与预后的关联,来刻画HER2阳性CRC的TIME特征。

通过免疫组化检测36例HER2阳性和72例HER2阴性CRC患者中CD3、CD4、CD8、CD20、CD68、叉头框蛋白P3(Foxp3)和程序性死亡配体1(PD-L1)的细胞密度来表征TIME。HER2阳性依据HERACLES标准进行评估。PD-L1表达通过肿瘤比例评分(TPS)和联合比例评分(CPS)进行评估。

在我们的研究中,HER2阳性CRC患者的CD3、CD4、CD8、CD20、CD68、Foxp3细胞密度和PD-L1表达与HER2阴性患者相比无统计学差异。HER2阳性CRC患者中Foxp3+细胞比例更高(≥ 10%)(P = .023)。尽管PD-L1 CPS与性别相关(P = .012),但炎症细胞和PD-L1 TPS与临床病理参数无关。此外,PD-L1 CPS ≥ 1的CRC患者无事件生存期(EFS)显著优于PD-L1 CPS < 1的患者(P = .029)。对于HER2阳性CRC患者,CD68较高提示EFS较好(P = .047)。

展开英文摘要原文

BACKGROUND: The human epidermal growth factor receptor 2 (HER2) status has been proposed as a biomarker to identify colorectal cancer (CRC) patients suitable for anti-HER2 treatment. However, response varies from HER2-negative CRC, influenced by factors such as the tumors immune microenvironment (TIME) in HER2-positive CRC patients. We aimed to characterize the TIME of HER2-positive CRC by assessing the associations of inflammatory cells and prognosis. METHODS: TIME was characterized through immunostaining for CD3, CD4, CD8, CD20, CD68, Forkhead box protein P3 (Foxp3), and programmed death-ligand 1 (PD-L1) cell densities in 36 HER2-positive and 72 HER2-negative CRC patients. HER2 positivity was evaluated by the HERACLES criteria. PD-L1 expression was evaluated by the tumor proportion score (TPS) and combined proportion score (CPS). RESULTS: In our study, the densities of CD3, CD4, CD8, CD20, CD68, Foxp3 cells and PD-L1 expression showed no statistic differences in HER2-positive CRC patients compared to HER2-negative patients. There was a greater proportion of Foxp3+ cells (≥ 10%) among patients with HER2-positive CRC (P = .023). Although the PD-L1 CPS was correlated with sex (P = .012), inflammatory cells and the PD-L1 TPS were not correlated with clinicopathological parameters. Additionally, CRC patients with PD-L1 CPSs ≥ 1 had significantly better event-free survival (EFS) than patients with PD-L1 CPSs < 1 (P = .029). For patients with HER2-positive CRC, higher CD68 indicated better EFS (P = .047). CONCLUSIONS: This study characterized a preliminary immune microenvironment profile and indicated CD68 increased correlation with EFS for HER2-positive CRC patients. These immune microenvironment profiles and prognostic implications could serve as potential biomarkers for stratifying patients with HER-2 positive for clinical trials.

论文信息

作者
Huang WW、Cheng YJ、Yuan SS、Liu Y、Liu FR
第一作者单位
Department of Clinical Research, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China.China
通讯作者单位
Department of Clinical Research, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, PR China. Electronic address: liufr@sysucc.org.cn.China
文献类型
非美国政府资助研究
期刊
Clinical colorectal cancer2025 Dec
原文标识
PubMed 40947372 · DOI 10.1016/j.clcc.2025.08.004