肿瘤浸润淋巴细胞（TILs）水平较高与预后较好相关，而 CDK5 在非转移性和转移性结直肠癌中发挥不同作用。
Higher Levels of Tumour-Infiltrating Lymphocytes (TILs) are Associated with a Better Prognosis, While CDK5 Plays a Different Role Between Nonmetastatic and Metastatic Colonic Carcinoma.
机构信息
Department of Medical Oncology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
Department of Pathology, The Affiliated Jinhua Hospital, Zhejiang University School of Medicine, Jinhua, China.
出版信息
Cancer Control. 2023 Jan-Dec;30:10732748231169396. doi: 10.1177/10732748231169396.
OBJECTIVE
We investigated the prognostic value of cyclin-dependent kinase 5 (CDK5) in a true population-based cohort of patients with colon cancer.
METHODS
- Immunohistochemical (IHC) staining was used to retrospectively analyse the expression of CDK5 in colon cancer tissue samples of 296 patients. The χ2 test, Kaplan-Meier method and Cox proportional regression model were used to analyse the difference between the patients with differential expression of CDK5 and with different stages (metastatic and nonmetastatic); 2. The number of tumour-infiltrating lymphocytes (TILs) in tumour sections was determined, and its relationship with prognosis was explored.
RESULTS
- Among 296 patients stained for CDK5, 18 cases (6.09%) showed negative expression, 77 cases (26.01%) showed weak expression (+1), 124 cases (41.89%) showed medium positive expression (2+), and 77 cases (26.01%) showed strong positive expression (3+). The expression of CDK5 was neither related to mismatch repair nor TILs ( > ). In non-metastatic patients, longer progression-free survival (PFS) and cancer-specific survival (CSS) were observed in patients with high CDK5 expression (2+ or 3+) than low CDK5 expression (- or 1+), while in metastatic disease, the opposite was true (). 2. TILs in 226 patients were detected in the study. Among them, 115 cases (50.88%) showed a low number of TILs (TILs-L), and 111 cases (49.12%) showed a high number of TILs (TILs-H). Patients with a TIL ratio greater than .2 had a significantly better CSS ( < ) or PFS () than patients with a lower TIL ratio. By multivariate analysis, TILs-H was a protective factor for CSS, however failed to reach a significant difference (hazard ratio: .59, 95% CI: .33∼1.06, ), and so was the PFS (HR: .65, 95% CI: .29∼1.43, ).
CONCLUSION
High expression of CDK5 indicates a good prognosis in nonmetastatic colon cancer, while it is the opposite in metastatic colon cancer, and the expression of CDK5 is unrelated to TILs. Patients with TIL-H have a better prognosis, with a proper cut-off value of 20% for colon cancer.
目的
我们研究了细胞周期蛋白依赖性激酶 5（CDK5）在真正基于人群的结肠癌患者队列中的预后价值。
方法
- 采用免疫组织化学（IHC）染色法对 296 例结肠癌组织标本中 CDK5 的表达进行回顾性分析。采用 χ2 检验、Kaplan-Meier 法和 Cox 比例风险回归模型分析 CDK5 表达差异的患者与不同分期（转移性和非转移性）患者之间的差异；2. 测定肿瘤组织切片中肿瘤浸润淋巴细胞（TILs）的数量，并探讨其与预后的关系。
结果
- 在 296 例 CDK5 染色患者中，18 例（6.09%）为阴性表达，77 例（26.01%）为弱阳性（+1），124 例（41.89%）为中等阳性（2+），77 例（26.01%）为强阳性（3+）。CDK5 的表达与错配修复无关，也与 TILs 无关（ > ）。在非转移性患者中，高 CDK5 表达（2+或 3+）的患者比低 CDK5 表达（-或 1+）的患者无进展生存期（PFS）和癌症特异性生存期（CSS）更长，而在转移性疾病中则相反（）。2. 在 226 例患者中检测到 TILs。其中，115 例（50.88%）TILs 数量较低（TILs-L），111 例（49.12%）TILs 数量较高（TILs-H）。TIL 比值大于.2 的患者 CSS（ < ）或 PFS（）明显优于 TIL 比值较低的患者。多因素分析显示，TILs-H 是 CSS 的保护因素，但差异无统计学意义（风险比：.59，95%CI：.33∼1.06，），PFS 也是如此（HR：.65，95%CI：.29∼1.43，）。
结论
CDK5 高表达提示非转移性结肠癌患者预后良好，而转移性结肠癌则相反，且与 TILs 无关。TIL-H 患者预后较好，结肠癌的合适截断值为 20%。
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