Jarosch Armin, Sommer Ulrich, Bogner Andreas, Reißfelder Christoph, Weitz Jürgen, Krause Mechthild, Folprecht Gunnar, Baretton Gustavo B, Aust Daniela E
Institute of Pathology, University Hospital and Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Germany.
National Center for Tumor Diseases (NCT) partner site Dresden.
Oncoimmunology. 2017 Nov 7;7(2):e1393133. doi: 10.1080/2162402X.2017.1393133. eCollection 2018.
Although neoadjuvant radiochemotherapy (nRCTx) is an established oncological treatment in patients with advanced rectal cancer, little is known about its effects on the tumor microenvironment. Quantity and composition of tumor infiltrating lymphocytes (TILs) are known to influence patients' prognosis but nRCTx-induced modifications are still unclear. We determined the composition of the immune cell infiltrate in rectal cancer after nRCTx and its influence on tumor regression, local recurrence rate and survival. We investigated density and composition of tumor infiltrating CD3 and CD8 T-cells and the quantity and ratio of CD8/GrzB T-cells to CD8 T-cells in 130 rectal cancers after nRCTx compared to a cohort of 30 primarily resected rectal cancers. Furthermore, we analyzed 22 pretherapeutic rectal cancer biopsies, later treated with nRCTx and surgery to evaluate nRCTx-induced modifications of the tumor microenvironment. The total numbers of CD3 and CD8 T-cells in tumor stroma (p < 0.001) and tumor epithelium (p < 0.001 CD3; 0.002 CD8) were significantly lower in rectal cancers after nRCTx compared to primarily resected cases, while the ratio of CD8/GrzB T-cells to CD8 T-cells was significantly increased in the nRCTx cohort (p < 0.001). In multivariate analyses, CD8/GrzB T-cells in the tumor stroma were significantly associated with high regression grade and a lower likelihood of local recurrence (p = 0.029). nRCTx modifies the tumor microenvironment of rectal cancer leading to a total decrease of TILs, but a relative increase in CD8/GrzB T-cells in the tumor stroma. CD8/GrzB T-cells may contribute to local tumor control and the better outcome.
尽管新辅助放化疗(nRCTx)是晚期直肠癌患者的一种既定肿瘤治疗方法,但其对肿瘤微环境的影响却知之甚少。已知肿瘤浸润淋巴细胞(TILs)的数量和组成会影响患者的预后,但nRCTx诱导的变化仍不清楚。我们确定了nRCTx后直肠癌中免疫细胞浸润的组成及其对肿瘤消退、局部复发率和生存率的影响。我们调查了130例nRCTx后的直肠癌中肿瘤浸润CD3和CD8 T细胞的密度和组成,以及CD8/GrzB T细胞与CD8 T细胞的数量和比例,并与30例原发性切除的直肠癌队列进行了比较。此外,我们分析了22例治疗前的直肠癌活检样本,这些样本后来接受了nRCTx和手术治疗,以评估nRCTx诱导的肿瘤微环境变化。与原发性切除病例相比,nRCTx后的直肠癌中肿瘤基质(p < 0.001)和肿瘤上皮(p < 0.001 CD3;0.002 CD8)中CD3和CD8 T细胞的总数显著降低,而nRCTx队列中CD8/GrzB T细胞与CD8 T细胞的比例显著增加(p < 0.001)。在多变量分析中,肿瘤基质中的CD8/GrzB T细胞与高消退分级和较低的局部复发可能性显著相关(p = 0.029)。nRCTx改变了直肠癌的肿瘤微环境,导致TILs总数减少,但肿瘤基质中CD8/GrzB T细胞相对增加。CD8/GrzB T细胞可能有助于局部肿瘤控制和更好的预后。