临床与病理杂志2018，Vol.38Issue(1)：47-54,8.DOI:10.3978/j.issn.2095-6959.2018.01.009
肿瘤微环境相关因子与直肠癌新辅助化学治疗疗效和预后的相关性
Correlation of tumor microenvironment related markers with the curative effect and prognosis of neoadjuvant chemotherapy of rectal cancer
摘要
Abstract
Objective: To observe the expression level of CD4, CD8, FOXP3, cytotoxic T lymphocyte associated antigen-4 (CTLA-4), programmed death ligand-l (PD-Ll) of tumor-infiltrating lymphocytes (TILs) in the tumor microenvironment before and after the neoadjuvant chemotherapy (NAC) of rectal cancer and to study the correlation of the expression of these immune markers with the curative effect and prognosis of NAC of rectal cancer. Methods: Immunohistochemical method was used to detect the 50 patients' changes in expression levels of CD4+ TILs, CD8+ TILs, FOXP3+ TILs, CTLA-4+ TILs and PD-L1+ TILs in or microenvironment before and after NAC, and analyses were conducted on the relationship between the expression of these markers and clinical therapeutic effect; besides, Kaplan-Meier method and COX proportional hazard regression analysis were used in survival analysis. Results: Compared with before NAC, the expression level of CD4+ TILs and CD8+TILs showed an evident increase after NAC of rectal cancer, with the statistically significant differences (P=0.002, P=0.001),while there was no statistical difference in the expression level of CTLA-4+ TILs and FOXP3+ TILs before and after NAC (P=0.094, P=0.068). PD-Ll in TILs and tumor cells was negatively expressed in rectal cancer. After the NAC of rectal cancer, the expression levels of CD4+ TILs and CD8+ TILs in the descending group were higher than those in the non-descending group) with the statistically significant differences (P=0.026, P=0.048). There was no statistic difference in the expression level of CTLA-4+ TILs and FOXP3+ TILs before and after NAC. In addition, higher level CD8+ TILs showed a higher survival rate. Conclusion: Increasing the expression level of CD8+ TILs and CD4+ TILs by immune system can impede the growing progress of tumor. The N staging of rectal cancer, CD4+ TILs, CD8+ TILs are the sensitive indices of the NAC curative effect, and the prognosis of rectal cancer patients who receive the NAC before the surgery is associated with the expression level ofCD8+ TILs.关键词
新辅助化学治疗/直肠癌/肿瘤微环境Key words
neoadjuvant chemotherapy/rectal cancer/tumor microenvironment引用本文复制引用
张思宇,彦风,步鹏,仝煦楠,徐菁..肿瘤微环境相关因子与直肠癌新辅助化学治疗疗效和预后的相关性[J].临床与病理杂志,2018,38(1):47-54,8.基金项目
山西省科技厅重点研发项目(201603 D321049)；山西省卫生和计划生育委员会科研课题(2014052)。This work was supported by the Major Research and Development Project of Shanxi Science and Technology Department (201603 D321049) （201603 D321049）
the Scientific Research Task of the Shanxi Health and Family Planning Commission (2014052), China. （2014052）
