Br J Cancer:免疫相关机制影响胃癌患者的生存率

2020-09-23 xiaozeng MedSci原创

在全球癌症发生中胃癌(GC)的发病率排名第五(5.7%),且在癌症相关死亡率中排名第三(8.2%)。在胃癌的几种分类系统中,Lauren分类法根据组织形态将GC分为肠道性和弥漫性胃癌。癌症基因组图集研

在全球癌症发生中胃癌(GC)的发病率排名第五(5.7%),且在癌症相关死亡率中排名第三(8.2%)。在胃癌的几种分类系统中,Lauren分类法根据组织形态将GC分为肠道性和弥漫性胃癌。癌症基因组图集研究网络(The Cancer Genome Atlas Research Network)近期则提出将GC分为四种亚型:(1)EB病毒阳性(爱泼斯坦-巴尔病毒,EBV);(2)水平的微卫星不稳定性(MSI);(3)基因组稳定性;(4)染色体不稳定性。这些分类均表明胃腺癌具有多种分子背景并可导致多种临床表现。

免疫疗法先已成为治疗各种类型癌症的一种具有潜力的策略。然而其在胃癌中的作用仍知之甚少。该研究旨在评估免疫细胞评分(CD3+,CD8+),肿瘤免疫逃逸(PD-L1,PD-1)和免疫耐受(Clever-1)的预后意义。

根据免疫细胞评分分类的胃腺癌患者的五年生存率

在排除EB病毒阳性(n = 4)和微卫星不稳定(n = 6)两类患者后,该研究共募集122例行D2胃癌切除术的患者。评价了基于CD3+和CD8+的免疫细胞评分(ICS),以及PD-L1、PD-1和Clever-1的表达水平。通过Cox回归模型分析患者的生存率差异,主要是5年生存率。

高PD-L1、PD-1和Clever- 1表达的高ICS患者的预后较差

研究显示,患者的5年总生存率为43.4%。相比于低ICS,高ICS对应着更高的总生存率。在高ICS组中,PD-L1、PD-1和Clever- 1高表达水平的患者的预后较差。


综上,该研究揭示,高ICS对应着患者较高的生存率。在高ICS组中,PD-L1、PD-1和Clever-1表达水平高的患者的预后较差,突出了在胃癌中免疫逃逸和免疫耐受的重要性。


原始出处:

Junttila, A., Helminen, O., V?yrynen, J.P. et al. Immunophenotype based on inflammatory cells, PD-1/PD-L1 signalling pathway and M2 macrophages predicts survival in gastric cancer. Br J Cancer (18 September 2020).

 

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    2020-09-24 肿肿

    机制研究离临床仍然有距离,不过与临床结合思考,仍然有帮助的,不能仅仅是纯临床思维,转化思维同样重要

    0

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    2020-09-23 Nebula-Qin

    免疫涉及多种疾病

    0

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