Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
Academic Unit of Surgery, School of Medicine, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom.
Eur J Cancer. 2014 Jan;50(2):309-19. doi: 10.1016/j.ejca.2013.09.008. Epub 2013 Oct 5.
The host immune response is important in the prevention of tumour progression in solid organ cancers. The aim was to evaluate the clinical utility of the local inflammatory response in patients with colorectal cancer.
Three hundred and sixty-five patients with primary operable colorectal cancer were included. The local inflammatory response was assessed using three different methods; (1) individual T-cell subtypes (CD3, CD8, CD45R0, FOXP3), (2) an immunohistochemistry-based immune score (Galon Immune Score) and (3) a histopathological assessment (Klintrup-Makinen grade). Relationships with tumour and host characteristics were established and the prognostic value of each method compared.
A strong infiltration of tumour infiltrating lymphoctyes (TIL's) was associated with improved cancer-specific survival. When individual T-cell subtypes were considered, CD3-positive cells were the strongest predictor of survival at the invasive margin (CD3(+) IM) while CD8-positive cells were the strongest predictor in the cancer cell nests (CD8(+) CCN). Infiltration of T-cells was related to early tumour stage, expanding growth pattern and lower levels of venous invasion but was not influenced by host characteristics or degree of systemic inflammation. In summary, CD3(+) IM, CD8(+) CCN, The Galon Immune Score and the Klintrup-Makinen grade all exhibited similar survival relationships in both node-positive and node-negative colorectal cancer.
A coordinated adaptive immune response is an important factor in predicting outcome in patients with primary operable colorectal cancer. By comparing different methodologies we have provided a foundation on which to develop a standardised approach for assessing the local inflammatory response in these patients.
宿主免疫反应对于预防实体器官癌症的肿瘤进展至关重要。本研究旨在评估结直肠癌患者局部炎症反应的临床应用价值。
纳入 365 例可手术治疗的原发性结直肠癌患者。采用三种不同方法评估局部炎症反应：（1）单个 T 细胞亚型（CD3、CD8、CD45RO、FOXP3），（2）基于免疫组化的免疫评分（Galon 免疫评分），（3）组织病理学评估（Klintrup-Makinen 分级）。评估肿瘤和宿主特征之间的关系，并比较每种方法的预后价值。
肿瘤浸润淋巴细胞（TILs）的强烈浸润与癌症特异性生存相关。当考虑单个 T 细胞亚型时，浸润边缘的 CD3 阳性细胞（CD3(+) IM）是生存的最强预测因子，而肿瘤细胞巢中的 CD8 阳性细胞（CD8(+) CCN）是最强的预测因子。T 细胞浸润与早期肿瘤分期、扩展生长模式和较低的静脉侵犯程度相关，但不受宿主特征或全身炎症程度的影响。综上所述，CD3(+) IM、CD8(+) CCN、Galon 免疫评分和 Klintrup-Makinen 分级在有淋巴结转移和无淋巴结转移的结直肠癌中均显示出相似的生存关系。
协调的适应性免疫反应是预测原发性可手术治疗结直肠癌患者预后的重要因素。通过比较不同的方法学，我们为评估这些患者局部炎症反应提供了一个标准化方法的基础。
