Association between cancer immunity and treatment results in uterine cervical cancer patients treated with radiotherapy
Association between cancer immunity and treatment results in uterine cervical cancer patients treated with radiotherapy
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DOI：
10.1093/jjco/hyaa149
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发表时间：
2020-11-01
影响因子：
2.4
通讯作者：
Sakata，Koh-ichi
中科院分区：
文献类型：
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作者：
Someya，Masanori;Tsuchiya，Takaaki;Sakata，Koh-ichi
目的探讨宫颈癌患者放疗后肿瘤免疫应答相关蛋白的表达及治疗效果。方法对81例宫颈癌患者进行回顾性免疫组织化学染色。检测肿瘤组织中程序性死亡配体1、人类白细胞抗原I类、肿瘤浸润性CD8+和叉头盒P3+T细胞的表达。结果活检标本中CD8+T细胞和FoxP3+T细胞数高的患者疾病特异性生存率明显高于CD8+T细胞和FoxP3+细胞数低的患者(P=0.018和P=0.009)。多因素分析显示，等量照射剂量(EQD2)最小剂量至高危临床靶区体积的90%、FoxP3+T细胞和人类白细胞抗原I类抗原表达是有意义的预后因素。当EQD2为70Gy或更高时，无论CD8或FoxP3阳性细胞的数量有多少，都能获得更高的局控率。当EQD2<70Gy时，CD8阳性细胞数对治疗结果有显著影响：CD8值230或以上组复发率(局部复发率+远处转移率)为46.2%，CD8值<230组复发率为75.7%。结论CD8或FoxP3与EQD2联合应用可预测宫颈癌放疗疗效，指导个体化优选治疗方案。
ObjectiveTo evaluate proteins related to tumor immune response and treatment outcome from radiotherapy for uterine cervical cancer patients.MethodsWe performed a retrospective immunohistochemical staining of 81 patients with uterine cervical cancer who underwent definitive radiotherapy. We examined the expression of programmed death ligand 1, human leukocyte antigen class I, tumor-infiltrating CD8+, and forkhead box P3+ (FoxP3+) T cells in tumor tissues.ResultsIn biopsy specimen, patients with a higher number of CD8+ T cells and FoxP3+ T cells had a better disease-specific survival than patients with a lower number of CD8+ T cells and FoxP3+ cells (P= 0.018 andP= 0.009). Multivariate analysis showed that equivalent dose in 2 Gy fractions (EQD2) of the minimum dose to 90% of the high-risk clinical target volume, FoxP3+ T cells and expression of human leukocyte antigen class I were significant prognostic factors. When the EQD2 is 70 Gy or more, a higher local control rate is obtained regardless of the number of CD8- or FoxP3-positive cells. When EQD2 is <70 Gy, the number of CD8-positive cells has a significant impact on treatment outcome: the recurrence rate (local recurrence rate + distant metastasis rate) was 46.2% in the group with a CD8 value of 230 or higher, whereas the recurrence rate was 75.7% in the group with a CD8 value of less than 230.ConclusionThe combination of CD8 or FoxP3 with EQD2 can be potentially useful to predict the treatment results of radiotherapy for cervical cancer, leading to individualized optimal selection of treatment for cervical cancer.