High post-chemotherapy TIL and increased CD4+TIL are independent prognostic factors of surgically resected NSCLC following neoadjuvant chemotherapy.
High post-chemotherapy TIL and increased CD4+TIL are independent prognostic factors of surgically resected NSCLC following neoadjuvant chemotherapy.
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作者：
Jia, Wenxiao;Guo, Hongbo;Wang, Min;Li, Ji;Yu, Jinming;Zhu, Hui;Wu, Gang
新辅助化疗（NCT）显著改善了可手术非小细胞肺癌（NSCLC）患者的总生存期。化疗可重塑肿瘤免疫微环境，对肿瘤免疫有重要影响。对于NCT后接受手术切除NSCLC（NCT-NSCLC）的患者，未接受过化疗和化疗后TIME之间的预后价值比较缺失。本研究入组了89例NCT-NSCLC患者，采用免疫组化染色检测初治和化疗后肿瘤组织中肿瘤浸润淋巴细胞（TIL）、CD 4 +TIL和CD 8 +TIL水平，并分为高、低两组。Kaplan-Meier分析显示，主要病理学缓解、病理肿瘤、淋巴结和NCT后转移分期（ypTNM）、化疗后高TIL、化疗后高CD 8 +TIL、低初始CD 4 +TIL、低初始CD 4 +/CD 8 +TIL比值和化疗后CD 4 +TIL水平升高是NCT-NSCLC患者的有利预后因素。多变量考克斯分析发现，ypTNM、化疗后高TIL和化疗后CD 4 +TIL水平升高是NCT‐NSCLC患者的独立预后因素。这些结果表明，通过化疗重塑的TIME在抗肿瘤免疫中起重要作用，并且比未处理的TIME具有更好的预后价值。NCT重塑了个体中CD 4 +TIL和CD 8 +TIL的浸润水平，这对抗肿瘤免疫至关重要，并与NCT-NSCLC的预后相关。ypTNM分期、化疗后TIL、CD 4 +TIL升高是NCT-NSCLC的独立预后因素。本研究表明化疗后重建的TIME比单纯TIME具有更好的预后价值。
Neoadjuvant chemotherapy (NCT) has significantly improved the overall survival of patients with operable non‐small cell lung cancer (NSCLC). Chemotherapy can remodel the tumor immune microenvironment (TIME) and has an important influence on antitumor immunity. For patients who underwent surgery for resected NSCLC following NCT (NCT‐NSCLC), a prognostic value comparison between naïve and post‐chemotherapy TIME is absent. We enrolled 89 patients with NCT‐NSCLC in this study; the tumor‐infiltrating lymphocyte (TIL), CD4+TIL, and CD8+TIL levels in naïve and post‐chemotherapy tumor tissues were detected using immunohistochemistry staining and divided into high and low groups. Kaplan–Meier analysis revealed that major pathology response, pathological tumor, node, and metastasis stage post‐NCT (ypTNM), high post‐chemotherapy TIL, high post‐chemotherapy CD8+TIL, low naïve CD4+TIL, low naïve CD4+/CD8+TIL ratio, and increased CD4+TIL levels post‐chemotherapy were favorable prognostic factors in patients with NCT‐NSCLC. Multivariate Cox analysis found that ypTNM, high post‐chemotherapy TIL, and increased CD4+TIL levels post‐chemotherapy were independent prognostic factors in patients with NCT‐NSCLC. These results indicate that a TIME remodeled by chemotherapy plays an important role in antitumor immunity and has a better prognostic value than the naïve TIME. NCT remodeled the infiltrating level of CD4+TIL and CD8+TIL in individuals, which is important for antitumor immunity and associated with the prognosis of NCT‐NSCLC. The ypTNM stage, post‐chemotherapy TIL, and CD4+TIL ascend post‐chemotherapy is independent prognostic factors of NCT‐NSCLC. This study indicated that TIME remodeled by chemotherapy has a better prognostic value than the naïve TIME.