直肠癌浸润T淋巴细胞密度预测放化疗敏感性的临床意义

发布时间：2018-03-22 16:37

本文选题：直肠癌　切入点：放化疗　出处：《广东医学》2017年22期 　论文类型：期刊论文

【摘要】：目的探讨直肠癌活检标本中肿瘤浸润T淋巴细胞(TILs)的密度对术前放化疗疗效的预测价值。方法收集99例经新辅助放化疗的局部晚期直肠癌患者资料,调取活检标本进行CD3免疫组化染色,计算肿瘤组织中CD3+TILs的密度,根据CD3+TILs的密度中位数将患者分为高密度组与低密度组,分析两组CD3+TILs的密度与放化疗后肿瘤退缩程度及患者预后的关系。结果 CD3+TILs密度中位数为180个细胞/40倍镜,CD3+TILs高密度和低密度的患者分别有49例和50例。CD3+TILs高密度组与CD3+TILs低密度组相比更容易获得肿瘤明显退缩(TRG1和2)(63.3%vs 42.0%,P=0.034)。CD3+TILs的密度与肿瘤浸润深度(T)、淋巴结受累(N)、肿瘤分化和治疗前癌胚抗原水平未见显著相关性。中位随访38个月,CD3+TILs高密度组与低密度组的3年无病生存率和总生存率差异无统计学意义(P=0.369,P=0.732)。结论直肠癌浸润CD3+T淋巴细胞密度可作为预测放化疗肿瘤退缩的有效指标,但其预后预测价值尚需进一步探讨。
[Abstract]:Objective to investigate the tumor biopsy specimens of rectal carcinoma infiltrating T lymphocytes (TILs) predictive value of the density on the efficacy of chemoradiotherapy before surgery. Methods 99 patients with neoadjuvant chemoradiotherapy in locally advanced rectal cancer patients, obtaining biopsy specimens for immunohistochemical staining of CD3, calculation of CD3+TILs density in the tumor tissue, according to the median density of CD3+TILs the patients were divided into groups of high density and low density group, analysis of the relationship between the primary tumors and the prognosis of patients of two groups of CD3+TILs and the density of chemotherapy. Results the median density of CD3+TILs 180 cells /40 magnification, CD3 +TILs high density and low density were 49 cases and 50 cases of.CD3+TILs high density group CD3+TILs with low density group easier to obtain significant tumor retraction (TRG1 and 2) (63.3%vs 42%, P=0.034.CD3+TILs) density and tumor invasion depth (T), lymph node involvement (N), tumor differentiation and treatment No carcinoembryonic antigen levels before treatment were significantly correlated. Median follow-up of 38 months, no statistically significant 3 years disease-free survival rate and overall survival rate between CD3+TILs group and high density low density group (P=0.369, P=0.732). Conclusion the infiltrating CD3+T lymphocyte density can be used as effective indicators of tumor therapy on prediction of withdrawal, but its prognostic value needs to be further explored.

【作者单位】：中山大学肿瘤防治中心结直肠科华南肿瘤学国家重点实验室肿瘤医学协同创新中心;
【基金】：广东省科技计划项目(编号:2013B021800146) 中山大学临床医学研究5010计划项目(编号:2014010)
【分类号】：R735.37

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