胰腺癌空间构型与新辅助治疗和根治性切除术后疾病复发相关
Spatial Configuration of Pancreatic Cancer Is Associated with Disease Recurrence after Neoadjuvant Therapy and Curative-Intent Resection.
从标准H&E切片量化的残留癌-间质拓扑结构在PDAC新辅助治疗后产生独立预后信号,为空间风险提供细胞免疫相关性依据,并推动前瞻性验证及空间信息指导的辅助治疗策略。
英文原题:Phenylalanine Hydroxylase as a Prognostic Marker in Pancreatic Cancer: Insights into Tumor Metabolism and Immune Microenvironment.
本研究首次揭示PAH作为代谢性免疫调节因子及术后PC患者的独立预后因素。PAH可能通过改变肿瘤微环境影响前列腺癌的结局。
肿瘤代谢相关基因参与肿瘤代谢重编程并重塑肿瘤微环境(TME),从而影响肿瘤进展和患者预后。然而,针对胰腺癌(PC)的研究有限。本研究探讨芳香族氨基酸代谢及其关键基因如何影响PC的TME和预后。
我们对多种癌症中芳香族氨基酸代谢相关基因进行了整合的多组学分析。PC队列中的患者被分为两个具有显著代谢异质性的亚型。分析了两个亚型患者的生存结局、代谢通路活性、肿瘤微环境特征和药物敏感性。确定了芳香族氨基酸代谢中的关键驱动基因,并在一个包含150例切除PC患者的独立队列中通过免疫组织化学进行了验证,同时评估了基因表达、免疫细胞浸润、成纤维细胞标志物和免疫检查点水平。
与芳香族氨基酸代谢相关的基因在多种癌症中显示出独特的变化和预后意义。这些氨基酸代谢水平较低与更好的临床结局相关。在一个独立验证队列中,苯丙氨酸羟化酶(PAH)的表达与PC患者的总生存期(OS)(p<0.05)和无病生存期(DFS)(p<0.05)相关。单因素分析(HR 2.017;p = 0.001)和多因素分析(HR 1.653;p = 0.028)均证实其作为独立预后因素的作用。PAH表达与CD8+ TILs呈正相关(p=0.002),与CAFs中的FAP呈负相关(p<0.05)。讨论:本研究确定PAH是胰腺癌进展的关键抑制因子,可能通过增强CD8+ T细胞浸润和抑制FAP+癌症相关成纤维细胞来重塑肿瘤免疫微环境。尽管这些发现突出了PAH的预后和治疗潜力,但仍需进一步的机制研究和临床前验证,以将这些见解转化为临床应用。
INTRODUCTION: Tumor metabolism-related genes participate in tumor metabolic reprogramming and reshape the tumor microenvironment (TME), thereby influencing tumor progression and patient prognosis. However, studies investigating pancreatic cancer (PC) are limited. This study examines how aromatic amino acid metabolism and its key genes influence the TME and prognosis in PC. METHOD: We performed an integrated multi-omics analysis of aromatic amino acid metabolism-related genes in various cancers. Patients in the PC cohort were classified into two subtypes with significant metabolic heterogeneity. Analysis of survival outcomes, metabolic pathway activity, tumor microenvironment characteristics, and drug sensitivity in patients with the two subtypes. Key driver genes in aromatic amino acid metabolism were identified and validated in a separate cohort of 150 resected PC patients using immunohistochemistry, with assessments of gene expression, immune cell infiltration, fibroblast markers, and immune checkpoint levels. RESULTS: Genes related to aromatic amino acid metabolism show unique changes and prognostic significance in various s cancers. Lower metabolism of these amino acids is linked to better clinical outcomes. In an independent validation cohort, the expression of phenylalanine hydroxylase (PAH) is associated with overall survival (OS) (p<0.05) and disease-free survival (DFS) (p<0.05) in patients with PC. Both univariate analysis (HR 2.017; p = 0.001) and multivariate analysis (HR 1.653; p = 0.028) corroborate its role as an independent prognostic factor. PAH expression correlated positively with CD8+ TILs (p=0.002) and negatively with FAP (p<0.05) in CAFs. DISCUSSIONS: This study identifies PAH as a critical suppressor of pancreatic cancer progression, potentially by remodeling the tumor immune microenvironment through the enhancement of CD8+ T-cell infiltration and the suppression of FAP+ cancer-associated fibroblasts. Although these findings highlight the prognostic and therapeutic potential of PAH, further mechanistic studies and preclinical validation are necessary to translate these insights into clinical applications. CONCLUSION: This study is the first to reveal PAH as a metabolic immunomodulator and an independent prognostic factor in postoperative PC patients. PAH may affect prostate cancer outcomes by altering the tumor microenvironment.
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