Department of Surgery, Gil Medical Center, School of Medicine, Gachon University, Incheon, Korea.
Ann Surg Oncol. 2013 Feb;20(2):697-702. doi: 10.1245/s10434-012-2752-1. Epub 2012 Dec 6.
The most reliable prognostic factor to date is tumor, node, metastasis stage. However, prognostic significance of tumor-infiltrating lymphocytes (TILs) in curatively resected stage IV colon cancer with isolated liver or lung lesion has not been clarified. The aim of this study was to assess and compare the prognostic role of TILs in curatively resected stage IV colon cancers.
Immunohistochemistry was used to assess the densities of CD8(+), CD45RO(+), and FOXP3(+) according to tumor sites (primary tumor, liver, and lung) from 79 stage IV colon cancers. These were evaluated for association with histopathologic features and patients' overall survival (OS).
Higher density of CD45RO(+) at primary and metastatic sites was associated with better patient outcomes (P = 0.009 and 0.027, respectively). The estimated 3-year OS rates for high-density CD45RO(+) at metastatic and primary sites was 82.6 and 62.4 %, respectively, compared to 60.8 and 27.1 % in low-density CD45RO(+). In multivariate analysis, CD45RO(+) at the colon primary site (P = 0.007; relative risk 0.108; 95 % confidence interval 0.021-0.546) was the strongest prognostic factor.
High density of CD45RO(+) TILs showed independent prognostic significance for OS. This result may help to improve the prognostication of curatively resected stage IV colon cancer.
迄今为止，最可靠的预后因素是肿瘤、淋巴结、转移分期。然而，在根治性切除的伴有孤立肝或肺转移的 IV 期结肠癌中，肿瘤浸润淋巴细胞（TILs）的预后意义尚不清楚。本研究旨在评估和比较 TILs 在根治性切除的 IV 期结肠癌中的预后作用。
免疫组织化学法用于评估 79 例 IV 期结肠癌患者的肿瘤部位（原发肿瘤、肝脏和肺部）的 CD8（+）、CD45RO（+）和 FOXP3（+）密度，并评估其与组织病理学特征和患者总生存（OS）的关系。
原发和转移部位 CD45RO（+）密度较高与患者预后较好相关（P=0.009 和 0.027）。高 CD45RO（+）密度在转移和原发部位的估计 3 年 OS 率分别为 82.6%和 62.4%，而低 CD45RO（+）密度分别为 60.8%和 27.1%。多因素分析显示，结肠原发部位的 CD45RO（+）（P=0.007；相对风险 0.108；95%置信区间 0.021-0.546）是最强的预后因素。
高 CD45RO（+）TIL 密度对 OS 具有独立的预后意义。这一结果可能有助于改善根治性切除的 IV 期结肠癌的预后预测。
