Okano Keiichi, Maeba Takashi, Moroguchi Akito, Ishimura Ken, Karasawa Yukihiko, Izuishi Kunihiko, Goda Fuminori, Usuki Hisashi, Wakabayashi Hisao, Maeta Hajime
First Department of Surgery, Kagawa Medical University, Kagawa, Japan.
J Surg Oncol. 2003 Jan;82(1):28-33. doi: 10.1002/jso.10188.
Tumor infiltrating lymphocytes (TILs) have been recognized as a tumor-host reaction in various primary neoplasms. Although several studies reported TILs surrounding metastatic liver tumors, to the authors' knowledge few evaluations of the clinical significance of such features in patients with colorectal liver metastases have been carried out.
Forty-one patients who underwent initial hepatic resection for liver metastases from colorectal cancer were studied. Lymphocytic infiltration surrounding metastatic liver tumor was graded as weak or dense according to the mean number of TILs from 10 high-power microscopic fields (< or =50 or >50/HPF).
Dense lymphocytic infiltration between the metastatic tumor and hepatic parenchyma was seen in 18 of 41 patients (44%). Histologically, tumor invasion of the portal vein was rare in patients with dense TILs (12%) compared with patients with weak TILs (36%). Patients with dense TILs survived longer than patients with weak TILs after hepatic resection (P = 0.013). Multivariate analysis using the Cox proportional hazard model identified this pathological variable as a significant independent prognostic factor after hepatic resection.
The extent of lymphocytic infiltration between the metastatic nodule and hepatic parenchyma may reflect host defensive activity in the liver and is closely related to prognosis in patients who underwent hepatic resection for liver metastases from colorectal cancer.
肿瘤浸润淋巴细胞（TILs）在多种原发性肿瘤中被视为一种肿瘤-宿主反应。尽管有多项研究报道了转移性肝肿瘤周围的TILs，但据作者所知，针对结直肠癌肝转移患者中此类特征的临床意义，很少有评估。
对41例行首次肝切除治疗结直肠癌肝转移的患者进行研究。根据10个高倍显微镜视野中TILs的平均数（≤50或>50/HPF），将转移性肝肿瘤周围的淋巴细胞浸润分级为弱或密集。
41例患者中有18例（44%）在转移性肿瘤与肝实质之间可见密集的淋巴细胞浸润。组织学上，与TILs弱的患者（36%）相比，TILs密集的患者门静脉受肿瘤侵犯的情况较少见（12%）。肝切除术后，TILs密集的患者比TILs弱的患者存活时间更长（P = 0.013）。使用Cox比例风险模型进行多因素分析发现，这一病理变量是肝切除术后一个显著的独立预后因素。
转移性结节与肝实质之间淋巴细胞浸润的程度可能反映肝脏中的宿主防御活性，并且与接受肝切除治疗结直肠癌肝转移患者的预后密切相关。
