Märkl Bruno, Wieberneit Johanna, Kretsinger Hallie, Mayr Patrick, Anthuber Matthias, Arnholdt Hans M, Schenkirsch Gerhard
From the Institute of Pathology
From the Institute of Pathology.
Am J Clin Pathol. 2016 Jun;145(6):826-36. doi: 10.1093/ajcp/aqw074. Epub 2016 Jun 21.
We postulated that lymph node (LN) harvest and LN size are influenced by immunologic effects.
To investigate this hypothesis, we performed a retrospective analysis of 170 node-negative colon cancer cases to evaluate the density of intratumoral T lymphocytes (ITLs). CD3- and CD8-positive T cells were counted using a digital system.
The ITL density was significantly increased in cases with sufficient LN harvest and high numbers of LNs larger than 5 mm (LN5). High ITL numbers were associated with improved cancer-specific survival. The analysis of the immune score revealed a significantly different cancer-specific outcome (P = .024), with no cancer-related death in the group with the highest score. The immune score and tumor budding were independently prognostic.
ITL density is independently prognostic and associated with LN harvest and LN size. The immune response is very likely the true explanation for the known prognostic effect of the LN harvest in colon cancer.
我们推测淋巴结（LN）清扫及LN大小受免疫效应影响。
为研究该假设，我们对170例淋巴结阴性结肠癌病例进行回顾性分析，以评估肿瘤内T淋巴细胞（ITL）密度。使用数字系统对CD3和CD8阳性T细胞进行计数。
在淋巴结清扫充分且有大量直径大于5mm的LN（LN5）的病例中，ITL密度显著增加。高ITL数量与癌症特异性生存率提高相关。免疫评分分析显示癌症特异性结局有显著差异（P = 0.024），评分最高组无癌症相关死亡。免疫评分和肿瘤芽生具有独立的预后价值。
ITL密度具有独立的预后价值，且与淋巴结清扫及LN大小相关。免疫反应很可能是已知的结肠癌淋巴结清扫预后效应的真正解释。
