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在患有食道状细胞癌的患者新辅助化疗期间瘤微环境的影响
Kotaro Sugawara1, Takashi Fukuda1, Chiaki Murakami2,3
1Department of Gastroenterological Surgery, Saitama Cancer Center, Saitama, Japan.
Cancer science
|May 2, 2024
概括
瘤微环境 (TME) 变化,而不是治疗前状态,影响化疗后食道癌存活率. 持续低的T细胞和高的PD-L1水平预测出差的结果,建议针对这些患者进行向治疗.
科学领域:
- 在瘤学瘤学.
- 免疫学 免疫学 免疫学
- 癌症研究 癌症研究
背景情况:
- 免疫检查点抑制剂 (ICI) 强调了瘤微环境 (TME) 在食道状细胞癌 (ESCC) 中的重要性.
- 了解新辅助化疗 (NAC) 后的TME动态对于预测患者结果至关重要.
研究的目的:
- 调查TME状态及其改变对ESCC患者的生存影响,这些患者接受了NAC并随后进行了手术.
- 确定特定的TME标记物及其与整体存活率 (OS) 相关的动态.
主要方法:
- 在264名ESCC患者的NAC前和NAC后瘤样本中,对TME标记物 (CD4+,CD8+,CD20+,Foxp3+,HLA类-1+,CD204+,PD-L1 CPS) 的免疫组织化学分析.
- 根据NAC前和后的免疫细胞状态以及NAC后观察到的变化来对患者进行分类.
- 多变量Cox危险分析以确定OS的独立预测因素.
主要成果:
- 在NAC前的TME状态与生存结果没有显著的相关性.
- 后NACTME状态,以低T细胞和CD4+T细胞水平以及高的PD-L1综合阳性得分 (CPS) 为特征,与糟糕的生存状况有关.
- 在NAC后的一致的TME变化 (低T细胞,低CD4+T细胞或高PD-L1CPS) 独立预测了不良的OS,与单独的NAC后状态不同.
结论:
- 在NAC之后,TME动态,特别是持续低的T细胞透率和高的PD-L1表达,是ESCC中糟糕的OS的关键预测因素.
- 患有这些TME概况的患者可能会从强化治疗策略中受益,包括ICI.
- 基于NAC TME后变化的分层对ESCC患者的个性化管理至关重要.
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