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辅助化疗在 II 期和 III 期结肠癌中的作用：“萌芽和 TILs（肿瘤浸润淋巴细胞）联合”作为肿瘤-宿主拮抗剂的作用。

Adjuvant chemotherapy in stage II and III colon cancer: the role of the "budding and TILs-(tumor-infiltrating lymphocytes) combination" as tumor-host antagonists.

机构信息

Institute of Pathology, Klinikum Bayreuth GmbH, Preuschwitzer Str. 101, 95445, Bayreuth, Germany.

Institute of Pathology, Koblenz, Franz-Weis-Str. 13, 56073, Koblenz, Germany.

出版信息

Int J Colorectal Dis. 2021 Aug;36(8):1765-1779. doi: 10.1007/s00384-021-03896-9. Epub 2021 Mar 20.

DOI:10.1007/s00384-021-03896-9
PMID:33745027
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8279987/
Abstract

PURPOSE

To analyze the influence of adjuvant chemotherapy on the combination of tumor budding and tumor-infiltrating lymphocytes (TILs) in stage II and III colon cancer and to elucidate its potential value for adjuvant treatment decisions.

METHODS

306 patients with stage II and 205 patients with stage III colon cancer diagnosed between 2005 and 2016 who had undergone surgery in a curative setting were enrolled. Budding and TILs were assessed according to the criteria of the International Tumor Budding Consensus Conference (ITBCC) and the criteria of the International TILs Working Group (ITWG). Combinations of budding and TILs were analyzed, and the influence of adjuvant chemotherapy was assessed.

RESULTS

In stage II colon cancer, stratification into the four budding/TILs groups showed no significant differences in overall survival (OS) between the chemotherapy and the surgery-alone group, not even in cases with high-risk features. In stage III colon cancer, patients with low budding/high TILs benefited significantly from chemotherapy (p=0.005). Patients with high budding/low TILs as well as high budding/high TILs showed a trend to benefit from adjuvant treatment. However, no chemotherapy benefit was seen for the low budding/low TIL group.

CONCLUSIONS

The budding/TIL combination identified subgroups in stage II and III colon cancer with and without benefit from adjuvant treatment. The results this study suggest that the combination of budding and TILs as tumor-host antagonists might be an additional helpful tool in adjuvant treatment decisions in stage II and III colon cancer.

摘要

目的

分析辅助化疗对 II 期和 III 期结肠癌中肿瘤芽和肿瘤浸润淋巴细胞（TILs）联合的影响，并阐明其对辅助治疗决策的潜在价值。

方法

本研究纳入了 2005 年至 2016 年间接受根治性手术的 306 例 II 期和 205 例 III 期结肠癌患者。根据国际肿瘤芽共识会议（ITBCC）和国际 TIL 工作组（ITWG）的标准评估芽和 TILs。分析了芽和 TILs 的联合情况，并评估了辅助化疗的影响。

结果

在 II 期结肠癌中，将 4 个芽/TILs 分组进行分层，在总生存（OS）方面，化疗组与手术组之间没有显著差异，即使在存在高危特征的情况下也是如此。在 III 期结肠癌中，低芽/高 TILs 的患者从化疗中显著获益（p=0.005）。高芽/低 TILs 以及高芽/高 TILs 的患者也有从辅助治疗中获益的趋势。然而，低芽/低 TIL 组则没有化疗获益。

结论

芽/TIL 联合确定了 II 期和 III 期结肠癌中有无辅助治疗获益的亚组。本研究的结果表明，作为肿瘤-宿主拮抗剂的芽和 TILs 的联合可能是 II 期和 III 期结肠癌辅助治疗决策的另一个有用工具。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/cc13c79abc57/384_2021_3896_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/63da730e0e1e/384_2021_3896_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/d1c8a3d50fac/384_2021_3896_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/3f82e38b6500/384_2021_3896_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/efc702970a28/384_2021_3896_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/137285427537/384_2021_3896_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/cc13c79abc57/384_2021_3896_Fig6_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/63da730e0e1e/384_2021_3896_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/d1c8a3d50fac/384_2021_3896_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/3f82e38b6500/384_2021_3896_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/efc702970a28/384_2021_3896_Fig4_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/137285427537/384_2021_3896_Fig5_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d0c/8279987/cc13c79abc57/384_2021_3896_Fig6_HTML.jpg

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