Department of Radiation Oncology, Gunma University Graduate School of Medicine, Maebashi, Japan;
Gunma University Heavy Ion Medical Center, Maebashi, Japan.
Anticancer Res. 2023 May;43(5):2077-2084. doi: 10.21873/anticanres.16368.
BACKGROUND/AIM: Prognostic factors, including CD8-positive tumor-infiltrating lymphocytes (CD8TILs), in definitive radiotherapy (RT) for squamous cell carcinoma (SqCC) of the uterine cervix need to be studied. This study aimed to explore these factors in a retrospective cohort.
Patients with SqCC who underwent definitive RT comprising external beam RT and intracavitary brachytherapy at our facility between April 2006 and November 2013 were evaluated. CD8 immunohistochemistry was performed in pre-treatment biopsy samples to analyze the prognostic significance of CD8TILs in the tumor nest. Positive staining was defined as at least one CD8 lymphocyte infiltrating the tumor area in the specimen.
In total, 150 consecutive patients were included. Among them, 66 (43.7%) patients had International Federation of Gynecology and Obstetrics (FIGO, 2008 edition) stage IIIA or higher progressive disease. The median follow-up period was 61 months. In the entire cohort, the 5-year cumulative rates of overall survival (OS), progression-free survival (PFS), and pelvic recurrence-free rate (PRFR) were 75.6%, 69.6%, and 84.8%, respectively. Of the 150 patients, 120 (80.0%) patients were CD8TIL positive. The independent favorable prognostic factors were FIGO stage I or II disease, administration of concurrent chemotherapy, and CD8TILs for OS (p=0.028, 0.005, and 0.038, respectively); FIGO stage I or II disease and CD8TILs for PFS (p=0.015 and <0.001, respectively); and CD8TILs for PRFR (p=0.017).
The presence of CD8TILs in the tumor nest may be a favorable prognostic factor of survival after definitive RT in patients with SqCC of the uterine cervix.
背景/目的：需要研究影响宫颈癌根治性放疗预后的因素，包括 CD8 阳性肿瘤浸润淋巴细胞（CD8TILs）。本研究旨在回顾性队列研究中探讨这些因素。
评估了 2006 年 4 月至 2013 年 11 月在我院接受根治性放疗（包括外照射放疗和腔内近距离放疗）的宫颈癌患者。在治疗前的活检样本中进行 CD8 免疫组化，以分析 CD8TILs 在肿瘤巢中的预后意义。阳性染色定义为标本中至少有一个 CD8 淋巴细胞浸润肿瘤区域。
共纳入 150 例连续患者。其中，66 例（43.7%）患者有国际妇产科联合会（FIGO，2008 年版）分期 IIIA 期及以上进展性疾病。中位随访时间为 61 个月。在整个队列中，总生存（OS）、无进展生存（PFS）和盆腔无复发生存率（PRFR）的 5 年累积率分别为 75.6%、69.6%和 84.8%。在 150 例患者中，120 例（80.0%）患者 CD8TIL 阳性。独立的有利预后因素为 FIGO 分期 I 或 II 期疾病、同期化疗的应用以及 CD8TILs 与 OS（p=0.028、0.005 和 0.038）相关；FIGO 分期 I 或 II 期疾病和 CD8TILs 与 PFS（p=0.015 和<0.001）相关；以及 CD8TILs 与 PRFR（p=0.017）相关。
肿瘤巢中存在 CD8TILs 可能是宫颈癌根治性放疗后生存的有利预后因素。
