Pretreatment Immune Status Correlates with Progression-Free Survival in Chemotherapy-Treated Metastatic Colorectal Cancer Patients
Pretreatment Immune Status Correlates with Progression-Free Survival in Chemotherapy-Treated Metastatic Colorectal Cancer Patients
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DOI：
10.1158/2326-6066.cir-15-0298
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发表时间：
2016-07-01
影响因子：
10.1
通讯作者：
Hamaguchi, Tetsuya
中科院分区：
文献类型：
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作者：
Tada, Kohei;Kitano, Shigehisa;Hamaguchi, Tetsuya
目前尚不清楚外周血中细胞的免疫状态是否可以作为不能切除的转移性结直肠癌(MCRC)患者治疗反应的预后指标。因此，我们调查了40例计划接受一线化疗的MCRC患者的治疗前免疫状态与其无进展生存期的关系。用多色流式细胞术检测25个免疫细胞亚群，包括单核细胞髓系来源的抑制细胞(M-MDSC)和效应记忆T细胞(TEM)。我们根据每个免疫细胞亚群的中位数将患者分为高和低(分别高于和低于中位数)组，并比较两组患者的无进展生存期。高M-MDSC、低CD_4(+)T-EM或低CD_8(+)T-EM的患者无进展生存期显著缩短(P分别为0.004、0.005和0.002)。根据不良因素的数量将患者分为两组；有两个或三个不良因素(n=21，52.5%)的患者与无或有一个不良因素(n=19，47.5%)的患者相比，无进展生存期显著缩短(P<；0.001)。两个或三个不良因素的存在是无进展生存的独立不良预后因素(HR，9.2；95%可信区间，2.5-34.2；P<；0.001)。这些结果提供了证据，证明治疗前的外周免疫状态可以影响接受一线化疗的MCRC患者的预后。
It remains unclear whether the immunologic status of cells in peripheral blood can be used as a prognostic indicator of response to treatment for patients with unresectable metastatic colorectal cancer (MCRC). We therefore investigated the relationship between the pretreatment immunologic status of 40 patients with MCRC who planned to receive the first-line chemotherapy and their progression-free survival. Twenty-five immune cell subsets, including monocytic myeloid-derived suppressor cells (M-MDSC) and effector memory T cells (TEM), were measured by multicolor-flow cytometry. We divided patients into high and low (above and below the median, respectively) groups based on the median value for each immune cell subset and compared progression-free survival of the two groups. Patients with high M-MDSC, low CD4(+) T-EM, or low CD8(+) T-EM quantities had significantly shorter progression-free survival (P = 0.004, 0.005, and 0.002, respectively). Patients were classified into two prognostic groups based on numbers of adverse factors; having two or three adverse factors (n = 21, 52.5%) was correlated with significantly shorter progression-free survival compared with none or one (n = 19, 47.5%; P < 0.001). The presence of two or three adverse factors was an independent poor prognostic factor for progression-free survival (HR, 9.2; 95% confidence interval, 2.5-34.2; P < 0.001). These results provide evidence that pretreatment peripheral immune status can inform the outcome of patients with MCRC treated with first-line chemotherapy.