Kemi Niko, Hiltunen Niko, Väyrynen Juha P, Pohjanen Vesa-Matti, Helminen Olli, Junttila Anna, Mrena Johanna, Böhm Jan, Huhta Heikki, Leppänen Joni, Karttunen Tuomo J, Kauppila Joonas H
Cancer and Translational Medicine Research Unit, Medical Research Centre, University of Oulu and Oulu University Hospital, 90220 Oulu, Finland.
Department of Pathology, Central Finland Central Hospital, 40620 Jyväskylä, Finland.
Cancers (Basel). 2020 Dec 2;12(12):3604. doi: 10.3390/cancers12123604.
To examine and compare the prognostic value of immune cell score (ICS) and Klintrup-Mäkinen (KM) grade in gastric cancer.
Gastric adenocarcinoma tissues from samples of 741 patients surgically treated in two hospitals in Finland were assessed for ICS and KM grade. Cox regression with adjustment for confounders provided hazard ratios (HRs) and 95% CIs. Subgroup analyses were performed in intestinal and diffuse type subgroups. The primary outcome was 5-year overall survival.
High ICS was associated to longer 5-year survival (adjusted HR 0.70, 95% CI 0.52-0.94), compared to low ICS. The difference was significant in intestinal type subgroup (adjusted HR 0.54, 95% CI 0.36-0.81) but not in diffuse type subgroup (adjusted HR 0.92, 95% CI 0.58-1.46). High KM grade was an independent prognostic factor for longer 5-year overall survival (adjusted HR 0.59, 95% CI 0.45-0.77) in both intestinal (adjusted HR 0.61, 95% CI 0.44-0.85) and diffuse subgroups (adjusted HR 0.52, 95% CI 0.31-0.86). ICS and KM grade were moderately correlated (ρ = 0.425). When both immune cell score and KM grade were included in the regression analysis, only KM grade remained prognostic.
Both ICS and KM grade are prognostic factors in gastric adenocarcinoma, but immunohistochemistry-based ICS might not have additional prognostic value over hematoxylin-eosin-based KM grade.
研究并比较免疫细胞评分（ICS）和克林特鲁普-马基宁（KM）分级在胃癌中的预后价值。
对芬兰两家医院手术治疗的741例患者的胃腺癌组织样本进行ICS和KM分级评估。通过对混杂因素进行调整的Cox回归分析得出风险比（HR）和95%置信区间（CI）。对肠型和弥漫型亚组进行亚组分析。主要结局指标为5年总生存率。
与低ICS相比，高ICS与更长的5年生存率相关（调整后HR为0.70，95%CI为0.52-0.94）。该差异在肠型亚组中显著（调整后HR为0.54，95%CI为0.36-0.81），但在弥漫型亚组中不显著（调整后HR为0.92，95%CI为0.58-1.46）。高KM分级是肠型（调整后HR为0.61，95%CI为0.44-0.85）和弥漫型亚组（调整后HR为0.52，95%CI为0.31-0.86）中更长的5年总生存率的独立预后因素。ICS与KM分级呈中度相关（ρ = 0.425）。当免疫细胞评分和KM分级都纳入回归分析时，只有KM分级仍具有预后意义。
ICS和KM分级都是胃腺癌的预后因素，但基于免疫组化的ICS相对于基于苏木精-伊红染色的KM分级可能没有额外的预后价值。
