Department of Thoracic Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan.
PLoS One. 2012;7(3):e33226. doi: 10.1371/journal.pone.0033226. Epub 2012 Mar 16.
Adjuvant tumor cell vaccine with chemotherapy against non-small cell lung cancer (NSCLC) shows limited clinical response. Whether it provokes effective cellular immunity in tumor microenvironment is questionable. Concomitant active tuberculosis in NSCLC (TBLC) resembles locoregional immunotherapy of tumor cell vaccine; thus, maximally enriches effective anti-tumor immunity. This study compares the survival and immunological cell profile in TBLC over NSCLC alone.
Retrospective review of NSCLC patients within 1-year-period of 2007 and follow-up till 2010.
A total 276 NSCLC patients were included. The median survival of TBLC is longer than those of NSCLC alone (11.6 vs. 8.8 month, p<0.01). Active tuberculosis is an independent predictor of better survival with HR of 0.68 (95% CI, 0.48 ~ 0.97). Squamous cell carcinoma (SCC) (55.8 vs. 31.7%, p<0.01) is a significant risk factor for NSCLC with active TB. The median survival of SCC with active tuberculosis is significantly longer than adenocarcinoma or undetermined NSCLC with TB (14.2 vs. 6.6 and 2.8 months, p<0.05). Active tuberculosis in SCC increases the expression of CD3 (46.4 ± 24.8 vs. 24.0 ± 16.0, p<0.05), CXCR3 (35.1 ± 16.4 vs. 19.2 ± 13.3, p<0.01) and IP-10 (63.5 ± 21.9 vs. 35.5 ± 21.0, p<0.01), while expression of FOXP3 is decreased (3.5 ± 0.5 vs. 13.3 ± 3.7 p<0.05, p<0.05). Survival of SCC with high expression of CD3 (12.1 vs. 3.6 month, p<0.05) and CXCR3 (12.1 vs. 4.4 month, p<0.05) is longer than that with low expression.
Active tuberculosis in NSCLC shows better survival outcome. The effective T lymphocyte infiltration in tumor possibly underlies the mechanism. Locoregional immunotherapy of tumor cell vaccine may deserve further researches.
针对非小细胞肺癌（NSCLC）的辅助肿瘤细胞疫苗联合化疗的临床反应有限。在肿瘤微环境中是否能引发有效的细胞免疫仍存在疑问。NSCLC 合并活动性肺结核（TBLC）类似于肿瘤细胞疫苗的局部免疫治疗；因此，最大限度地增加了有效的抗肿瘤免疫。本研究比较了 TBLC 与单纯 NSCLC 患者的生存和免疫细胞特征。
回顾性分析了 2007 年 1 年内和 2010 年随访的 NSCLC 患者。
共纳入 276 例 NSCLC 患者。TBLC 的中位生存时间长于 NSCLC 单独治疗（11.6 个月比 8.8 个月，p<0.01）。活动性肺结核是生存的独立预测因素，HR 为 0.68（95%CI，0.48~0.97）。鳞状细胞癌（SCC）（55.8%比 31.7%，p<0.01）是 NSCLC 合并活动性肺结核的显著危险因素。SCC 合并活动性肺结核的中位生存时间明显长于腺癌或未确定的 NSCLC 合并 TB（14.2 个月比 6.6 个月和 2.8 个月，p<0.05）。SCC 中的活动性肺结核增加了 CD3（46.4±24.8 比 24.0±16.0，p<0.05）、CXCR3（35.1±16.4 比 19.2±13.3，p<0.01）和 IP-10（63.5±21.9 比 35.5±21.0，p<0.01）的表达，而 FOXP3 的表达降低（3.5±0.5 比 13.3±3.7，p<0.05）。高表达 CD3（12.1 个月比 3.6 个月，p<0.05）和 CXCR3（12.1 个月比 4.4 个月，p<0.05）的 SCC 患者的生存时间长于低表达患者。
NSCLC 合并活动性肺结核的患者有较好的生存结局。肿瘤中有效 T 淋巴细胞浸润可能是其机制。肿瘤细胞疫苗的局部免疫治疗可能值得进一步研究。
