Moldovan Valentin Tiberiu, Sajin María, Ali Leila
Doctoral School, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
Department of Pathology, Centre Hospitaller de Troyes, France.
Maedica (Bucur). 2024 Jun;19(2):233-238. doi: 10.26574/maedica.2024.19.2.233.
Extra-gastrointestinal stromal tumors (EGISTs) are non-gastrointestinal sarcomas originating from Cajal-like cells. Recent studies show the tumor microenvironment is crucial and highlight the importance of intra-tumoral leukocyte populations in malignancies, which are greatly impacting treatment strategies in EGISTs.
This study aims to characterize intra-tumoral leukocyte populations in EGISTs, correlating proliferative index (ki67) with leukocyte density and examining age-related effects on proliferative activity and immune response.
We conducted a retrospective analysis on 25 patients with EGIST who came at "Victor Babes" National Institute of Pathology and Bucharest University Emergency Hospital between January 2007 and June 2020. After excluding five patients, a total of 19 subjects were included in the present study. Immunohistochemistry utilizing CD5, CD20, CD45 and ki67 antibodies identified and assessed intratumoral lymphocytes, analyzed via QuPath software. Statistical analyses included Pearson correlation, Kruskal-Wallis tests and Bonferroni corrections.
The mean age of patients diagnosed with EGIST was 51 years; ki67 expression varied among morphological types. Immunohistochemistry revealed distinct tumor-infiltrating lymphocytes (TIL) densities with significant associations between ki67 and TIL-CD05/CD20 positive cells. Age-related correlations were noted, which highlighted complexities within the tumor microenvironment.
Our findings emphasize the role of the immune microenvironment in EGISTs, showing significant correlations between ki67 expression and TIL densities as well as age-related associations. This study enhances our understanding of EGIST pathophysiology, urging further exploration for improved therapeutic approaches and comprehensive insights into immune responses in EGISTs.
胃肠道外间质瘤（EGISTs）是起源于类 Cajal 细胞的非胃肠道肉瘤。近期研究表明肿瘤微环境至关重要，并凸显了肿瘤内白细胞群体在恶性肿瘤中的重要性，这对 EGISTs 的治疗策略产生了重大影响。
本研究旨在对 EGISTs 中的肿瘤内白细胞群体进行特征分析，将增殖指数（ki67）与白细胞密度相关联，并研究年龄对增殖活性和免疫反应的影响。
我们对 2007 年 1 月至 2020 年 6 月期间在“维克托·巴比什”国家病理研究所和布加勒斯特大学急诊医院就诊的 25 例 EGIST 患者进行了回顾性分析。排除 5 例患者后，本研究共纳入 19 名受试者。利用 CD5、CD20、CD45 和 ki67 抗体进行免疫组织化学，鉴定并评估肿瘤内淋巴细胞，通过 QuPath 软件进行分析。统计分析包括 Pearson 相关性分析、Kruskal-Wallis 检验和 Bonferroni 校正。
诊断为 EGIST 的患者平均年龄为 51 岁；ki67 表达在形态学类型之间存在差异。免疫组织化学显示不同的肿瘤浸润淋巴细胞（TIL）密度，ki67 与 TIL-CD05/CD20 阳性细胞之间存在显著关联。注意到与年龄相关的相关性，这凸显了肿瘤微环境中的复杂性。
我们的研究结果强调了免疫微环境在 EGISTs 中的作用，显示 ki67 表达与 TIL 密度之间存在显著相关性以及与年龄相关的关联。本研究增进了我们对 EGIST 病理生理学的理解，促使进一步探索改进的治疗方法以及对 EGISTs 免疫反应的全面认识。
