结直肠癌肝转移患者免疫微环境的临床意义及变化
Clinical significance and changes to the immune microenvironment of colorectal cancer patients with liver metastasis.
作者信息
Wang Ting, Tang Long, Ouyang Bing, Chen Xingyue, Qi Jun
机构信息
Internal Medicine-Oncology, Chongqing University Cancer Hospital, Chongqing, China.
Phase I Clinical Trial Ward, Chongqing University Cancer Hospital, Chongqing, China.
出版信息
J Gastrointest Oncol. 2023 Feb 28;14(1):206-212. doi: 10.21037/jgo-22-1169. Epub 2023 Feb 1.
BACKGROUND
Liver metastasis is common in colorectal cancer patients. Immunotherapy covers a wide range of tumor types and is safer than traditional radiotherapy and chemotherapy. However, its overall effective rate is only 20-40%. At present, there is a lack of relevant research clarifying whether the changes and clinical significance of the immune microenvironment in colorectal cancer patients with liver metastasis are conducive to enhancing the promotion and further improving the efficacy of immunotherapy.
METHODS
We retrospectively collected the data of 50 colorectal cancer patients with liver metastasis treated in Chongqing University Cancer Hospital from January 2017 to January 2019. Liver metastatic cancer tissues and normal liver tissues were collected to detect the levels of immune cells in the two samples. At the same time, the correlation between T-cell subsets in the liver metastatic cancer tissue immune microenvironments of colorectal cancer patients and prognosis was analyzed.
RESULTS
Compared with the normal liver tissues, the level of T helper cell 1/T helper cell 2 (Th1/Th2) in the liver metastatic cancer tissues was significantly decreased (0.88±0.24 . 1.34±0.27, P=0.000), while the levels of regulatory T cells were markedly increased (8.57±2.31 . 6.89±1.71, P=0.000). The Th1/Th2 level in liver metastatic cancer tissue exhibited a good predictive value for recurrence and survival 3 years after surgery, and the areas under the curves were 0.783 (95% confidence interval: 0.649-0.916, P=0.002) and 0.763 (95% confidence interval: 0.628-0.898, P=0.001), respectively. Moreover, the regulatory T-cell level in liver metastatic cancer tissue had a good predictive value for recurrence and survival at 3 years postoperatively, and the areas under the curves were 0.788 (95% confidence interval: 0.656-0.919, P=0.002) and 0.763 (95% confidence interval: 0.628-0.897, P=0.001), respectively.
CONCLUSIONS
The immunosuppressive condition of liver metastasis in colorectal cancer patients was related to poor prognosis.
背景
肝转移在结直肠癌患者中很常见。免疫疗法涵盖多种肿瘤类型，且比传统放疗和化疗更安全。然而，其总体有效率仅为20% - 40%。目前，缺乏相关研究阐明结直肠癌肝转移患者免疫微环境的变化及其临床意义是否有利于增强免疫疗法的促进作用并进一步提高疗效。
方法
我们回顾性收集了2017年1月至2019年1月在重庆大学附属肿瘤医院接受治疗的50例结直肠癌肝转移患者的数据。收集肝转移癌组织和正常肝组织，检测两个样本中的免疫细胞水平。同时，分析结直肠癌患者肝转移癌组织免疫微环境中T细胞亚群与预后的相关性。
结果
与正常肝组织相比，肝转移癌组织中辅助性T细胞1/辅助性T细胞2（Th1/Th2）水平显著降低（0.88±0.24 对1.34±0.27，P = 0.000），而调节性T细胞水平显著升高（8.57±2.31对6.89±1.71，P = 0.000）。肝转移癌组织中的Th1/Th2水平对术后3年的复发和生存具有良好的预测价值，曲线下面积分别为0.783（95%置信区间：0.649 - 0.916，P = 0.002）和0.763（95%置信区间：0.628 - 0.898，P = 0.001）。此外，肝转移癌组织中的调节性T细胞水平对术后3年的复发和生存具有良好的预测价值，曲线下面积分别为0.788（95%置信区间：0.656 - 0.919，P = 0.002）和0.763（95%置信区间：0.628 - 0.897，P = 0.001）。
结论
结直肠癌患者肝转移的免疫抑制状态与预后不良有关。
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