Rao Qunxian, Huang Miaoling, Guan Meimei, Liu Changhao, Wang Lijuan, Lin Zhongqiu, Chen Qing
Department of Gynecologic Oncology, Sun Yat-sen Memorial Hospital, Guangzhou, Guangdong, China.
Med Sci Monit. 2024 Jul 17;30:e943170. doi: 10.12659/MSM.943170.
BACKGROUND Tumor-infiltrating immune cells (TIICs) are implicated in the survival of ovarian cancer (OVCA) patients, but their prognostic significance in advanced or metastatic OVCA patients treated with neoadjuvant chemotherapy (NCAT) has not been well documented, particularly in the Chinese population. MATERIAL AND METHODS A total of 31 advanced or metastatic OVCA patients who underwent NACT were included. The density and positive rate of tumor-infiltrating immune cells (TIICs) within cancer cell nests and in cancer stroma were explored. The correlations of pre- or post-NACT TIICs with the efficacy of NACT and the changes in TIIC subpopulation with NACT were examined. RESULTS Compared with patients with partial benefit from NACT, significantly decreased pre-NACT intratumoral CD68⁺CD163⁺ cells (P=0.0043) and increased pre-NACT intratumoral CD56⁺ cells (P=0.038) were observed in patients with benefit. The high level of pre-NACT intratumoral CD68⁺CD163⁻ M1 macrophage (P=0.075) and stromal CD3⁺PD-1⁺ cells (P=0.085) predicated improved progression-free survival, respectively. Increased post-NACT stromal CD68⁺CD163⁻ M1 macrophage (P=0.01), stromal CD8⁺ T cells (P=0.073), and stromal CD8⁺PD-1⁺ cells (P=0.072) were associated with benefit from NACT. Moreover, NACT increased intratumoral CD3⁺ (P=0.031), CD8+ (P=0.031), and CD3⁺CD8⁺ cells (P=0.031). CONCLUSIONS High intratumoral CD68⁺CD163⁻, intratumoral CD56⁺ cells, and stromal CD3⁺PD-1⁺ cells pre-NACT predicted good prognosis. Intratumoral CD3⁺, CD8⁺, and CD3⁺CD8⁺ cells were increased after NACT. Evaluation of immune profiles may help to identify patients who might benefit from NACT and allow us to further stratify advanced or metastatic OVCA patients treated with NACT for disease management.
背景 肿瘤浸润免疫细胞（TIICs）与卵巢癌（OVCA）患者的生存相关，但其在接受新辅助化疗（NCAT）的晚期或转移性OVCA患者中的预后意义尚未得到充分记录，尤其是在中国人群中。
材料与方法 共纳入31例接受NACT的晚期或转移性OVCA患者。探讨癌细胞巢内和癌基质中肿瘤浸润免疫细胞（TIICs）的密度和阳性率。研究NACT前后TIICs与NACT疗效的相关性以及TIIC亚群随NACT的变化。
结果 与NACT部分获益的患者相比，获益患者术前瘤内CD68⁺CD163⁺细胞显著减少（P=0.0043），术前瘤内CD56⁺细胞增加（P=0.038）。术前瘤内高水平的CD68⁺CD163⁻ M1巨噬细胞（P=0.075）和基质CD3⁺PD-1⁺细胞（P=0.085）分别预示无进展生存期改善。NACT后基质CD68⁺CD163⁻ M1巨噬细胞增加（P=0.01）、基质CD8⁺ T细胞增加（P=0.073）和基质CD8⁺PD-1⁺细胞增加（P=0.072）与NACT获益相关。此外，NACT使瘤内CD3⁺（P=0.031）、CD8⁺（P=0.031）和CD3⁺CD8⁺细胞增加（P=0.031）。
结论 术前瘤内高表达CD68⁺CD163⁻、瘤内CD56⁺细胞和基质CD3⁺PD-1⁺细胞预示良好预后。NACT后瘤内CD3⁺、CD8⁺和CD3⁺CD8⁺细胞增加。评估免疫谱可能有助于识别可能从NACT中获益的患者，并使我们能够进一步对接受NACT治疗的晚期或转移性OVCA患者进行分层以进行疾病管理。
