肿瘤浸润淋巴细胞在恶性腹膜间皮瘤中的临床意义：一项143例单中心研究

Clinical Significance of Tumor-Infiltrating Lymphocytes in Malignant Peritoneal Mesothelioma: A Single-Center Study of 143 Cases.

作者信息

Wu He-Liang, Yang Rui, Liang Xin-Li, Ma Ru, Su Yan-Dong, Yang Zhi-Ran, Cui Yu-Run, Du Xue-Mei, Liu Yi-Tong, Li Yan

机构信息

Department of Peritoneal Cancer Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China.

Department of Peritoneal Oncology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Changping District, Beijing, China.

出版信息

Ann Surg Oncol. 2025 May 15. doi: 10.1245/s10434-025-17437-z.

DOI:10.1245/s10434-025-17437-z

PMID:40372588

Abstract

BACKGROUND

Malignant peritoneal mesothelioma (MPM) is a rare malignant tumor with high mortality rate and extremely poor prognosis. The tumor immune microenvironment, particularly tumor-infiltrating lymphocytes (TILs), plays a critical role in disease progression and treatment response. This study aimed to analyze the correlation between the level of TILs and the main clinicopathological characteristics and prognosis of MPM.

PATIENTS AND METHODS

A total of 143 postoperative specimens from patients with MPM following cytoreductive surgery were collected. Postoperative specimens were stained with hematoxylin and eosin (H&E). The level of TILs was quantitatively analyzed by QuPath 0.3.2 software. Univariate and multivariate analyses were conducted to investigate the correlation between TILs level and other conventional clinicopathological characteristics.

RESULTS

Among the 143 patients with MPM, 73 were male (51.0%) and 70 were female (49.0%), with a median age of 55 (range 24-73) years. There were 72 (50.3%) cases with low TILs, and 71 (49.7%) cases with high TILs. Univariate analysis showed that TIL level (low versus high) was negatively correlated with the following seven clinicopathological factors: surgery history, Ki-67 index, preoperative CA125 level, peritoneal cancer index (PCI) index, bleeding volume, red blood cell (RBC) transfusion volume, and ascites volume (all P < 0.05). Multivariate analysis indicated that TIL level was independently negatively correlated with preoperative carbohydrate antigen (CA)125 level (odds ratio 0.394, 95% CI 0.179-0.866, P = 0.020). Cox regression analysis suggested that high TILs was independently associated with better prognosis of MPM. Moreover, a cohort of patients who received preoperative chemotherapy combined with targeted therapy were evaluated for response. Kaplan-Meier curve showed that high infiltration of TILs predicted better overall survival in patients undergoing treatment.

CONCLUSIONS

TILs could be a useful indicator for predicting prognosis and guiding personalized treatment strategies in patients with MPM.

摘要

背景

恶性腹膜间皮瘤（MPM）是一种罕见的恶性肿瘤，死亡率高，预后极差。肿瘤免疫微环境，尤其是肿瘤浸润淋巴细胞（TILs），在疾病进展和治疗反应中起关键作用。本研究旨在分析TILs水平与MPM主要临床病理特征及预后的相关性。

患者与方法

收集了143例接受减瘤手术后的MPM患者的术后标本。术后标本用苏木精和伊红（H&E）染色。采用QuPath 0.3.2软件对TILs水平进行定量分析。进行单因素和多因素分析，以研究TILs水平与其他传统临床病理特征之间的相关性。

结果

143例MPM患者中，男性73例（51.0%），女性70例（49.0%），中位年龄55岁（范围24 - 73岁）。低TILs患者72例（50.3%），高TILs患者71例（49.7%）。单因素分析显示，TIL水平（低与高）与以下七个临床病理因素呈负相关：手术史、Ki-67指数、术前CA125水平、腹膜癌指数（PCI）、出血量、红细胞（RBC）输血量和腹水量（所有P < 0.05）。多因素分析表明，TIL水平与术前糖类抗原（CA）125水平独立呈负相关（比值比0.394，95%置信区间0.179 - 0.866，P = 0.020）。Cox回归分析表明，高TILs与MPM的较好预后独立相关。此外，对一组接受术前化疗联合靶向治疗的患者进行了反应评估。Kaplan-Meier曲线显示，TILs的高浸润预测接受治疗患者的总生存期更好。