Prognostic Significance of Tumor-Infiltrating Lymphocytes in Patients With Pancreatic Ductal Adenocarcinoma Treated With Neoadjuvant Chemotherapy.
Prognostic Significance of Tumor-Infiltrating Lymphocytes in Patients With Pancreatic Ductal Adenocarcinoma Treated With Neoadjuvant Chemotherapy.
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DOI：
10.1097/mpa.0000000000000914
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发表时间：
2017-10
期刊：
影响因子：
2.9
通讯作者：
Wang H
中科院分区：
文献类型：
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作者：
Nejati R;Goldstein JB;Halperin DM;Wang H;Hejazi N;Rashid A;Katz MH;Lee JE;Fleming JB;Rodriguez-Canales J;Blando J;Wistuba II;Maitra A;Wolff RA;Varadhachary GR;Wang H
检测新辅助治疗后胰腺导管腺癌 (PDAC) 患者的肿瘤浸润淋巴细胞 (TIL) 及其预后价值。使用计算机辅助定量分析对 136 名接受新辅助治疗和胰十二指肠切除术的 PDAC 患者进行免疫组织化学检查肿瘤内 CD4+、CD8+ 和 FOXP3+ 淋巴细胞。结果与临床病理参数和生存率相关。治疗后的 PDAC 中高 CD4+ TIL 与高 CD8+ TIL (P = 0.003)、分化 (P = 0.04) 和较低的复发频率 (P = 0.02) 相关。高 CD4+ TIL 的患者比低 CD4+ TIL 的患者有更长的无病生存期 (DFS) 和总生存期 (OS) (P < 0.01)。 CD8+/FOXP3+ 淋巴细胞比率高的患者（39.5 [标准差，6.1] 个月）的中位 OS 长于 CD8+/FOXP3+ 淋巴细胞比率低的患者（28.3 [标准差，2.3] 个月；P=0.01）。在多变量分析中，高 CD4+ TIL 是 DFS 的独立预后因素 [风险比 (HR)：0.49，95% CI，0.30–0.81； P = 0.005] 和 OS（HR，0.54；95% CI，0.33–0.89；P = 0.02）。高 CD4+ 淋巴细胞与肿瘤分化、较低的复发率相关，并且是接受新辅助治疗的 PDAC 患者生存的独立预后因素。
To examine tumor infiltrating lymphocytes (TILs) and their prognostic value in patients with pancreatic ductal adenocarcinoma (PDAC) after neoadjuvant therapy. Intra-tumoral CD4+, CD8+, and FOXP3+ lymphocytes was examined by immunohistochemistry using a computer-assisted quantitative analysis in 136 PDAC patients who received neoadjuvant therapy and pancreaticoduodenectomy. The results were correlated with clinicopathologic parameters and survival. High CD4+ TILs in treated PDAC were associated with high CD8+ TILs (P = 0.003), differentiation (P = 0.04) and a lower frequency of recurrence (P = 0.02). Patients with high CD4+ TILs had longer disease-free survival (DFS) and overall survival (OS) than did patients with low CD4+ TILs (P < 0.01). The median OS of patients with a high CD8+/FOXP3+ lymphocyte ratio (39.5 [standard deviation, 6.1] months) was longer than that of patients with a low CD8+/FOXP3+ lymphocyte ratio (28.3 [standard deviation, 2.3] months; P=0.01). In multivariate analysis, high CD4+ TILs were an independent prognostic factor for DFS [Hazard ratio (HR): 0.49, 95% CI, 0.30–0.81; P = 0.005] and OS (HR, 0.54; 95% CI, 0.33–0.89; P = 0.02). High CD4+ lymphocytes is associated with tumor differentiation, lower recurrence and is an independent prognostic factor for survival in PDAC patients treated with neoadjuvant therapy.