Teng Feifei, Meng Xiangjiao, Wang Xin, Yuan Jupeng, Liu Sujing, Mu Dianbin, Zhu Hui, Kong Li, Yu Jinming
Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China.
Shandong Provincial Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China.
Oncotarget. 2016 Sep 27;7(39):64318-64329. doi: 10.18632/oncotarget.11793.
Currently, adjuvant chemotherapy is recommended for patients with high risk stage I non-small cell lung cancer (NSCLC). However, identifying high risk patients remains a challenge. This study aims to identify the patient cohorts more likely to benefit from adjuvant chemotherapy based on the tumor micro-immune environment.
CD8+TILs significantly associated with disease-free survival (DFS) and overall survial (OS) (p=0.002; 0.040). Patients with high risk factors may also predict shorter DFS (P=0.056). When compared together, patients with high-CD8+TILs showed better DFS than patients with low-CD8+TILs, no matter their risk factors status. There's no correlation between PD-L1 expressions and survival. PD-L1 was highly expressed in men, squamous and well differentiated carcinoma. In addition, Foxp3+TILs alone didn't show any prognostic effects, but low-Foxp3/high-CD8+TILs were associated with prolonged DFS (p=0.031).
A total of 126 patients with surgically resected stage I NSCLC were included to perform immunohistochemistry of CD8+ tumor infiltrating lymphocytes (TILs), programmed death ligand-1(PD-L1) and forkhead box P3 (Foxp3)+TILs.
CD8+TILs are effective prognostic predictors. Patients with surgically resected stage I NSCLC showing low CD8+TILs could be considered for adjuvant chemotherapy, even if they have no high risk features.
目前，对于高危Ⅰ期非小细胞肺癌（NSCLC）患者推荐进行辅助化疗。然而，识别高危患者仍然是一项挑战。本研究旨在基于肿瘤微免疫环境识别更可能从辅助化疗中获益的患者队列。
CD8+肿瘤浸润淋巴细胞（TILs）与无病生存期（DFS）和总生存期（OS）显著相关（p = 0.002；0.040）。具有高危因素的患者也可能预示着较短的DFS（P = 0.056）。当进行比较时，无论其危险因素状态如何，高CD8+TILs患者的DFS均优于低CD8+TILs患者。PD-L1表达与生存之间无相关性。PD-L1在男性、鳞状细胞癌和高分化癌中高表达。此外，单独的Foxp3+TILs未显示任何预后作用，但低Foxp3/高CD8+TILs与延长的DFS相关（p = 0.031）。
共纳入126例接受手术切除的Ⅰ期NSCLC患者，进行CD8+肿瘤浸润淋巴细胞（TILs）、程序性死亡配体-1（PD-L1）和叉头框P3（Foxp3）+TILs的免疫组织化学检测。
CD8+TILs是有效的预后预测指标。对于手术切除的Ⅰ期NSCLC患者，即使没有高危特征，若CD8+TILs水平低，也可考虑进行辅助化疗。
