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结直肠癌肝转移患者肝切除术后,组织病理生长模式与免疫评分相关。

Histopathological growth patterns correlate with the immunoscore in colorectal cancer liver metastasis patients after hepatectomy.

机构信息

State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.

Department of Medical Oncology, Sun Yat-Sen University Cancer Center, Guangzhou, People's Republic of China.

出版信息

Cancer Immunol Immunother. 2020 Dec;69(12):2623-2634. doi: 10.1007/s00262-020-02632-6. Epub 2020 Jun 29.

Abstract

Various scoring systems have been proposed to predict the postoperative prognosis of colorectal liver metastasis (CRLM), including the clinical risk score (CRS), the immunoscore and so on. Recently, histopathological growth patterns (HGPs) have been recognized. However, the correlation between HGPs and the immunoscore, and their prognostic values in patients with CRLM after liver resection remain undetermined. In this study, HGPs were retrospectively evaluated in H&E-stained slides from 166 CRLM patients. The immunoscore was calculated according to the densities of immunostained CD3 + and CD8 + cells. A risk score combining HGPs, the immunoscore and the CRS was defined and divided patients into the low-, medium- and high-risk group. Our results showed that the densities of CD3 + and CD8 + cells were higher in the desmoplastic HGP (dHGP) group than in the non-dHGP group, and the proportion of high immunoscores was also higher in the dHGP group (51.9% vs. 33.0%, respectively, P = 0.020). Patients with the dHGP had significantly longer relapse-free survival (RFS) and overall survival (OS) than those with the non-HGP. The low-risk group showed significantly higher 2-year RFS and 5-year OS rates than the other two groups (RFS: 76.2%, 43.7% and 33.1%, respectively; P < 0.001; OS: 89.7%, 54.4% and 33.3%, respectively; P < 0.001). In conclusion, the dHGP correlates with relatively high immunoscores, predicting a favorable prognosis independent of the immunoscore and CRS. A novel risk score combining HGPs, the immunoscore and the CRS may be used for the stratification of CRLM patients' survival.

摘要

各种评分系统已被提出以预测结直肠癌肝转移(CRLM)的术后预后,包括临床风险评分(CRS)、免疫评分等。最近,组织病理学生长模式(HGPs)已被认识到。然而,HGPs 与免疫评分之间的相关性,以及它们在接受肝切除术后 CRLM 患者中的预后价值仍不确定。在这项研究中,对 166 例 CRLM 患者的 H&E 染色切片进行了 HGPs 的回顾性评估。根据免疫染色的 CD3+和 CD8+细胞密度计算免疫评分。定义了一个结合 HGPs、免疫评分和 CRS 的风险评分,并将患者分为低风险、中风险和高风险组。我们的结果表明,在纤维母细胞性 HGP(dHGP)组中,CD3+和 CD8+细胞的密度高于非 dHGP 组,并且 dHGP 组中高免疫评分的比例也更高(分别为 51.9%和 33.0%,P=0.020)。具有 dHGP 的患者的无复发生存(RFS)和总生存(OS)显著长于非 dHGP 患者。低风险组的 2 年 RFS 和 5 年 OS 率显著高于其他两组(RFS:76.2%、43.7%和 33.1%,P<0.001;OS:89.7%、54.4%和 33.3%,P<0.001)。总之,dHGP 与相对较高的免疫评分相关,独立于免疫评分和 CRS 预测有利的预后。一种结合 HGPs、免疫评分和 CRS 的新的风险评分可能用于分层 CRLM 患者的生存。

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