Department of Surgery, Nara Medical University, 840 Shijo-cho, Kashihara, Nara, 634-8522, Japan.
Langenbecks Arch Surg. 2023 Feb 1;408(1):72. doi: 10.1007/s00423-023-02815-6.
Tumor-infiltrating lymphocytes (TILs) may influence the prognosis of colorectal liver metastasis (CRLM). We assessed the prognostic value of evaluating TILs in the primary and metastatic sites of synchronous CRLM as well as metachronous CRLM.
We examined 90 patients who underwent curative primary and liver metastasis resection for colorectal cancer. CD8 TILs (cytotoxic T cells) or CD45RO TILs (memory T cells) in both primary and metastatic sites were simultaneously evaluated by immunohistochemistry.
Fifty-one patients had synchronous CRLM, and 39 patients had metachronous CRLM. In synchronous cases, the overall survival (OS) was significantly worse in patients with low CD8 or CD45RO TILs in a metastatic site than in those with high CD8 or CD45RO TILs (P = 0.017 and P = 0.005, respectively). Multivariate analysis showed that age ≥ 65 years (P = 0.043), maximum tumor size ≥ 30 mm (P = 0.003), primary N2-3 (P = 0.019), and low CD8 TILs in metastatic site (P = 0.046) were independent poor prognostic factors. In contrast, in metachronous cases, OS was significantly worse in patients with low CD45RO TILs in a primary site than in those with high CD45RO TILs (P = 0.021). CD45RO TILs in a primary site (P = 0.044) were determined to be independent prognostic factor on multivariate analysis.
The immune microenvironment between synchronous and metachronous CRLM might be different, and these differences may affect its prognosis.
肿瘤浸润淋巴细胞（TILs）可能影响结直肠癌肝转移（CRLM）的预后。我们评估了评估同步和异时性 CRLM 原发和转移部位 TILs 的预后价值。
我们检查了 90 例接受结直肠癌根治性原发和肝转移切除术的患者。通过免疫组织化学同时评估原发和转移部位的 CD8 TIL（细胞毒性 T 细胞）或 CD45RO TIL（记忆 T 细胞）。
51 例患者为同步 CRLM，39 例患者为异时性 CRLM。在同步病例中，与 CD8 或 CD45RO TIL 高的患者相比，转移部位 CD8 或 CD45RO TIL 低的患者总体生存率（OS）显著更差（P=0.017 和 P=0.005）。多变量分析显示，年龄≥65 岁（P=0.043）、最大肿瘤直径≥30mm（P=0.003）、原发 N2-3（P=0.019）和转移部位 CD8 TIL 低（P=0.046）是独立的不良预后因素。相比之下，在异时性病例中，原发部位 CD45RO TIL 低的患者 OS 显著更差，而 CD45RO TIL 高的患者 OS 更好（P=0.021）。多变量分析显示，原发部位 CD45RO TIL 是独立的预后因素（P=0.044）。
同步和异时性 CRLM 的免疫微环境可能不同，这些差异可能影响其预后。
