Wang Lin, Zhai Zhi-Wei, Ji Deng-Bo, Li Zhong-Wu, Gu Jin
Department of Colorectal Surgery, Peking University Cancer Hospital and Institute, Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), 52 Fu Cheng Lu, Haidian district, Beijing, 100142, People's Republic of China.
Int J Colorectal Dis. 2015 Jun;30(6):753-60. doi: 10.1007/s00384-015-2226-6. Epub 2015 May 3.
This study aims to evaluate the prognostic value of CD45RO(+) tumor-infiltrating lymphocytes (TILs) in locally advanced rectal cancer treated with 30 Gy/10 fraction (10 f) neoadjuvant radiotherapy.
This retrospective study involved 185 patients with locally advanced rectal cancer who underwent 30 Gy/10 f nRT (biologic equivalent dose, 30 Gy) followed by total mesorectal excision (TME) between August 2003 and October 2009. The density of CD45RO(+) TILs was assessed by immunohistochemistry using an image-analysis system and tissue microarray and was evaluated for its association with histopathologic features along with disease-free survival (DFS).
Following neoadjuvant radiotherapy, the median density of CD45RO(+) TILs is 654/mm(2). High density of CD45RO(+) TILs was significantly associated with increased T and N downstaging effect (p = 0.006; p = 0.014), lesser-advanced T stage (p = 0.003) and TNM stage (p = 0.022). Prolonged DFS (89.0 vs. 68.1%) was also observed in CD45RO(+Hi) cases. On multivariate regression model, CD45RO(+) TILs (p = 0.026; odds ratio (OR), 0.436 (95% confidence interval (CI), 0.209-0.907)), tumor differentiation (p = 0.057; OR, 1.878 (95% CI, 0.982-3.593)), ypT stage (p = 0.066; OR, 2.383 (95% CI, 0.943-6.025)), and ypN stage (p = 0.009; OR, 2.612 (95% CI, 1.266-5.388)) were independent factors for DFS.
The density of CD45RO(+) TILs cannot only predict tumor downstaging and ypTNM stage for rectal cancer following 30 Gy/10 f nRT but also promisingly predict long-term outcomes. These findings may be used to stratify patients and make alternative strategy of adjuvant treatment.
本研究旨在评估CD45RO(+)肿瘤浸润淋巴细胞（TILs）在接受30 Gy/10次分割（10 f）新辅助放疗的局部晚期直肠癌中的预后价值。
本回顾性研究纳入了185例局部晚期直肠癌患者，这些患者在2003年8月至2009年10月期间接受了30 Gy/10 f的新辅助放疗（生物等效剂量，30 Gy），随后行全直肠系膜切除术（TME）。使用图像分析系统和组织芯片通过免疫组织化学评估CD45RO(+) TILs的密度，并评估其与组织病理学特征以及无病生存期（DFS）的相关性。
新辅助放疗后，CD45RO(+) TILs的中位密度为654/mm²。CD45RO(+) TILs的高密度与T和N降期效果增加显著相关（p = 0.006；p = 0.014），T分期较晚（p = 0.003）和TNM分期（p = 0.022）较低。在CD45RO(+Hi)病例中也观察到DFS延长（89.0%对68.1%）。在多变量回归模型中，CD45RO(+) TILs（p = 0.026；比值比（OR），0.436（95%置信区间（CI），0.209 - 0.907））、肿瘤分化（p = 0.057；OR，1.878（95% CI，0.982 -
