Immunoscore system combining CD8 and PD-1/PD-L1: A novel approach that predicts the clinical outcomes for cervical cancer
Immunoscore system combining CD8 and PD-1/PD-L1: A novel approach that predicts the clinical outcomes for cervical cancer
复制标题
结合 CD8 和 PD-1/PD-L1 的免疫评分系统：预测宫颈癌临床结果的新方法
DOI：
10.1177/1724600819888771
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发表时间：
2020-03-01
影响因子：
2
通讯作者：
Lou, Ge
中科院分区：
文献类型：
--
作者：
Chen, Hong;Xia, Bairong;Lou, Ge
目的：建立免疫评分，评价肿瘤患者的预后。然而，免疫评分对宫颈癌预后的可行性尚不清楚。为了找到其他具有免疫学重要性的预后标志物，针对程序性细胞死亡蛋白（PD-1）或其配体PD-L1的免疫检查点抑制剂引起了极大的兴趣。我们的目的是研究CD8和PD-1/PD-L1的表达及其在免疫评分中的潜在作用，以补充宫颈癌的肿瘤/淋巴结/转移（TNM）分类。方法：采用免疫组化方法，根据PD-1、PD-L1、CD8的密度进行免疫评分。通过Kaplan-Meier法评估与总生存期和无病生存期的关系。为了评价免疫评分的效果，进行了Cox比例风险回归分类。为了比较免疫评分和TNM分期的预后准确性，绘制了受试者工作特征曲线。结果：免疫细胞中PD-L1（阳性）和PD-1（高）的患者总生存期和无病生存期较差；然而，浸润更多CD8(+) T细胞的肿瘤细胞中的PD-L1（阳性）与更好的总生存期和无病生存期相关。这些免疫因素可以作为预后的独立预测因素。根据这些因素，建立了一个新的免疫评分系统，优先预测预后。在预测总生存期（曲线下面积(AUC) = 0.833 vs. 0.766）和无病生存期（AUC = 0.861 vs. 0.729）的受试者工作特征分析中，Immunoscore比TNM分期更准确。结论：该免疫评分系统是一种准确的预测指标，可作为宫颈癌TNM分期的重要补充。
Purpose:Immunoscore was established to evaluate the prognosis of cancer patients. However, the feasibility of Immunoscore for the prognosis of cervical cancer remains unknown. To find other prognostic markers that contribute to immunological importance, immune checkpoint inhibitors targeting programmed cell death protein (PD-1), or its ligand, PD-L1, are of enormous interest. Our purpose is to investigate the expression of CD8 and PD-1/PD-L1 and their potential role in Immunoscore, supplementing the tumor/node/metastasis (TNM) classification of cervical cancer.Methods:Immunoscore was assessed according to the density of PD-1, PD-L1, and CD8 by immunohistochemistry. The association with overall survival and disease-free survival was assessed by the Kaplan-Meier method. To evaluate the effect of Immunoscore, a Cox proportional hazard regression classification was conducted. To compare the prognostic accuracies of Immunoscore and TNM staging, receiver operating characteristic curves were plotted.Results:Patients with PD-L1(positive) and PD-1(high) in immune cells had poorer overall survival and disease-free survival; however, PD-L1(positive) in tumor cells that infiltrated more CD8(+) T cells were related to better overall survival and disease-free survival. These immune factors can be independent predictors for prognoses. According to these factors, a new Immunoscore system with priority in predicting prognoses was established. In receiver operating characteristic analysis for predictions of overall survival (the area under curve (AUC) = 0.833 vs. 0.766) and disease-free survival (AUC = 0.861 vs. 0.729), Immunoscore is more accurate than TNM staging.Conclusions:Thus, this Immunoscore system is an accurate predictive marker, which can be an important supplement to TNM staging for cervical cancer.