Immunoscore Signatures in Surgical Specimens and Tumor-Infiltrating Lymphocytes in Pretreatment Biopsy Predict Treatment Efficacy and Survival in Esophageal Cancer

医学 危险系数 食管癌 活检 CD8型 癌症 免疫组织化学 肿瘤浸润淋巴细胞 生存分析 免疫系统 CD3型 胃肠病学 肿瘤科 病理 内科学 比例危险模型 新辅助治疗 免疫疗法 置信区间 免疫学
作者
Toshiki Noma,Tomoki Makino,Kenji Ohshima,Keijiro Sugimura,Hiroshi Miyata,Keiichiro Honma,Kotaro Yamashita,Takuro Saito,Koji Tanaka,Kazuyoshi Yamamoto,Tsuyoshi Takahashi,Yukinori Kurokawa,Makoto Yamasaki,Kiyokazu Nakajima,Eiichi Morii,Hidetoshi Eguchi,Yuichiro Doki
出处
期刊:Annals of Surgery [Ovid Technologies (Wolters Kluwer)]
卷期号:Publish Ahead of Print 被引量:5
标识
DOI:10.1097/sla.0000000000005104
摘要

Tumor-infiltrating lymphocytes (TILs) have long been recognized as playing an important role in tumor immune microenvironment. Lately, the Immunoscore (IS) has been proposed as a new method of quantifying the number of TILs in association with patient survival in several cancer types.In 300 preoperatively untreated esophageal cancer (EC) patients who underwent curative resection at two different institutes, immunohistochemical staining using CD3 and CD8 antibodies was performed to evaluate IS, as objectively scored by auto-counted TILs in the tumor core and invasive margin. In addition, in pre-neoadjuvant chemotherapy (pre-NAC) endoscopic biopsies of a different cohort of 146 EC patients who received NAC, CD3, and CD8 were immunostained to evaluate TIL density.In all cases, the IS-high (score 3-4) group tended to have better survival [5-year overall survival (OS) of the IS-high vs low group: 77.6 vs 65.8%, P = 0.0722] than the IS-low (score 1-2) group. This trend was more remarkable in cStage II-IV patients (70.2 vs 54.5%, P = 0.0208) and multivariate analysis of OS further identified IS (hazard ratio 2.07, P = 0.0043) to be an independent prognostic variable. In preNAC biopsies, NAC-responders had higher densities than non-responders of both CD3 + ( P = 0.0106) and CD8 + cells ( P = 0.0729) and, particularly CD3 + cell density was found to be an independent prognostic factor (hazard ratio 1.75, P = 0.0169).The IS signature in surgical specimens and TIL density in preNAC- biopsies could be predictive markers of clinical outcomes in EC patients.
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