Lancet:免疫评分可用于预测结肠癌患者的五年复发风险

2018-05-11 MedSci MedSci原创

必须提高对结肠癌患者复发风险的评估。需要一个强大的免疫评分量化表将免疫参数引入癌症分类。近日,Lancet杂志上发表一篇文章,研究人员对肿瘤中浸润的全部T细胞计数和细胞毒性T细胞对I-III期结肠癌的预后意义进行评估。本研究是在13个国家的14个中心开展的一国际性研究,评估免疫评分是否可用于预测TNM I-III期结肠癌患者的预后。患者被随机分至训练组、内部验证组或外部验证组。对每个患者的结肠肿瘤

必须提高对结肠癌患者复发风险的评估。需要一个强大的免疫评分量化表将免疫参数引入癌症分类。近日,Lancet杂志上发表一篇文章,研究人员对肿瘤中浸润的全部T细胞计数和细胞毒性T细胞对I-III期结肠癌的预后意义进行评估。

本研究是在13个国家的14个中心开展的一国际性研究,评估免疫评分是否可用于预测TNM I-III期结肠癌患者的预后。患者被随机分至训练组、内部验证组或外部验证组。对每个患者的结肠肿瘤和浸润边缘的石蜡切片进行免疫组化,并量化肿瘤和浸润边缘的CD3+和细胞毒性CD+ T细胞的密度。通过密度的四分位均值换算患者的免疫评分。主要结点:评估免疫评分对从手术到疾病复发的时间的预测价值。采用多种统计学方式处理结果。

共对3539位患者的组织样本进行免疫组化,经质量控制后,其中2681位患者的样本被纳入分析(训练组 700人、内部验证组 636人、外部验证组1345人)。免疫评分显示观察者和中心间的重复性很高(结肠癌 r=0.97;浸润边缘 r=0.97;p<0.0001)。在训练组,高免疫评分的患者五年复发风险最低(高、中、低免疫评分复发患者分别是14[8%]位、65[19%]和51[32%],高评分与低评分的风险比[HR]0.20,95% CI 0.10-0.38;p<0.0001)。在两个验证组中观察到同样的结果。在分层Cox多变量分析中,免疫评分与复发时间的关系与患者年龄、性别、T分期、N分期、微卫星灶不稳定性和现有的预后因素均无关(p<0.0001)。在1434位II期癌症患者中,五年复发风险差异明显(高评分与低评分的HR 0.33,95% CI 0.21-0.52;p<0.0001),在Cox多变量分析中也是如此(p<0.0001)。在所有临床风险因素中,免疫评分贡献度相对最大。

免疫评分为结肠癌患者的复发风险提供可靠的估计。本研究结果支持将免疫评分纳入癌症的TNM免疫分类。

原始出处:

Franck Pages,et al.International validation of the consensus Immunoscore for the classification of colon cancer: a prognostic and accuracy study.The Lancet.May 10,2018.https://doi.org/10.1016/S0140-6736(18)30789-X

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    2018-06-06 蔬菜

    谢谢分享.有学习了最新研究成果!

    0

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    2019-01-20 howi
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    2018-05-11 1e17414fm02(暂无匿称)

    学习

    0

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    2018-05-11 清风拂面

    谢谢分享学习

    0

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