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组织病理学生长模式和肿瘤浸润淋巴细胞在结直肠癌肝转移肝切除术后生存分层中的预后意义

Prognostic Significance of the Histopathological Growth Pattern and Tumor-Infiltrating Lymphocytes in Stratifying Survival After Hepatectomy for Colorectal Liver Metastases.

作者信息

Kanno Hiroki, Hisaka Toru, Fujiyoshi Kenji, Akiba Jun, Hashimoto Kazuaki, Fujita Fumihiko, Akagi Yoshito

机构信息

Department of Surgery, Kurume University School of Medicine, Kurume, Japan.

Department of Diagnostic Pathology, Kurume University Hospital, Kurume, Japan.

出版信息

Ann Surg Oncol. 2023 May;30(5):3139-3147. doi: 10.1245/s10434-022-12905-2. Epub 2022 Dec 15.

Abstract

BACKGROUND

A histopathological growth pattern (HGP) occurs at the interface between tumor cells and the surrounding liver parenchyma. Desmoplastic HGP (dHGP) is associated with a favorable prognosis and shows denser infiltration of lymphocytes than other HGPs. Tumor-infiltrating lymphocytes (TILs) exert antitumor immunity, nonetheless, their prognostic significance in patients with dHGP is unknown. This study aimed to identify the prognostic significance of HGP and TILs in colorectal liver metastasis (CRLM).

METHODS

The study analyzed 140 patients who underwent hepatectomy for CRLM. Depending on the type of HGP and TIL, the patients were categorized into four groups (dHGP/high TIL, dHGP/low TIL, non-dHGP/high TIL, and non-dHGP/low TIL) for a comparison of their recurrence-free survival (RFS) and overall survival (OS). Uni- and multivariate analyses were performed using a Cox proportional hazards model.

RESULTS

The RFS and OS curves differed significantly between the groups. The multivariate analysis showed that a combination of HGP and TIL could stratify the recurrence and survival outcomes.

CONCLUSION

This study indicated that a combination of HGP and TIL can stratify the risk of survival after hepatectomy in patients with CRLM.

摘要

背景

组织病理学生长模式(HGP)出现在肿瘤细胞与周围肝实质的界面处。促结缔组织增生性HGP(dHGP)与良好的预后相关,并且与其他HGP相比显示出更密集的淋巴细胞浸润。肿瘤浸润淋巴细胞(TILs)发挥抗肿瘤免疫作用,然而,它们在dHGP患者中的预后意义尚不清楚。本研究旨在确定HGP和TILs在结直肠癌肝转移(CRLM)中的预后意义。

方法

该研究分析了140例行CRLM肝切除术的患者。根据HGP和TIL的类型,将患者分为四组(dHGP/高TIL、dHGP/低TIL、非dHGP/高TIL和非dHGP/低TIL),以比较其无复发生存期(RFS)和总生存期(OS)。使用Cox比例风险模型进行单因素和多因素分析。

结果

各组之间的RFS和OS曲线有显著差异。多因素分析表明,HGP和TIL的组合可以对复发和生存结果进行分层。

结论

本研究表明,HGP和TIL的组合可以对CRLM患者肝切除术后的生存风险进行分层。

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