Peter MacCallum Cancer Centre, Melbourne, Australia.
J Surg Oncol. 2021 Jan;123(1):117-126. doi: 10.1002/jso.26261. Epub 2020 Oct 20.
Limited literature exists examining the immune microenvironment in liposarcoma, particularly with regard to the impact of radiotherapy. A major problem is the lack of scoring system for the tumour-infiltrating lymphocytes (TILs) in sarcoma. This study aims to describe the immune environment pre- and postradiotherapy and identify the optimal immune infiltrate scoring system for sarcoma.
Thirty-nine paired tissue samples (pre- and postradiotherapy) from patients with liposarcoma were scored by two pathologists for TILs using pre-existing systems (for breast cancer and melanoma) and compared for interobserver reliability. Immunohistochemical staining was performed for various immune markers.
The TIL scoring system for breast cancer yielded perfect agreement (κ = 1.000). 21% of patients had increased TILs after radiotherapy, 87.5% of whom had dedifferentiated liposarcoma. Immune suppressor expression was increased frequently after radiotherapy (CD68 increased in 59.4%, PD-L1 increased in 25%). Immune effector expression (CD8) was unchanged in 84.4%.
Breast cancer TIL scoring is reproducible in liposarcoma and has high interobserver reliability. Radiotherapy was observed to have a limited impact on immune effectors but seemed to have more impact in upregulating immune suppressors, suggesting radiotherapy may contribute to disease control through immunomodulatory effects. Dedifferentiated liposarcoma represents a uniquely responsive subtype.
关于脂肪肉瘤的免疫微环境，尤其是放疗的影响，相关文献有限。一个主要问题是缺乏用于肉瘤肿瘤浸润淋巴细胞（TILs）的评分系统。本研究旨在描述放疗前后的免疫环境，并确定用于肉瘤的最佳免疫浸润评分系统。
对 39 对脂肪肉瘤患者的配对组织样本（放疗前和放疗后），由两位病理学家使用现有的（用于乳腺癌和黑色素瘤的）系统进行 TIL 评分，并比较观察者间的可靠性。进行了各种免疫标志物的免疫组织化学染色。
乳腺癌 TIL 评分系统具有完美的一致性（κ=1.000）。21%的患者在放疗后 TIL 增加，其中 87.5%为去分化脂肪肉瘤。放疗后免疫抑制因子的表达常常增加（59.4%的 CD68 增加，25%的 PD-L1 增加）。免疫效应因子（CD8）的表达在 84.4%中没有变化。
乳腺癌 TIL 评分在脂肪肉瘤中具有可重复性和较高的观察者间可靠性。放疗对免疫效应因子的影响有限，但似乎在上调免疫抑制因子方面影响更大，这表明放疗可能通过免疫调节作用有助于控制疾病。去分化脂肪肉瘤是一种独特的反应性亚型。
