Prediction of treatment response from the microenvironment of tumor immunity in cervical cancer patients treated with chemoradiotherapy
Prediction of treatment response from the microenvironment of tumor immunity in cervical cancer patients treated with chemoradiotherapy
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DOI：
10.1007/s00795-021-00290-w
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发表时间：
2021-05-08
影响因子：
1.8
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
为了补充宫颈癌管理中的临床决策，在接受确定性放化疗的宫颈癌患者中检查了各种预后因素，包括肿瘤免疫微环境。我们回顾性分析了100例宫颈癌中CD 8、FoxP 3、HLA-1、PD-L1和XRCC 4的表达。观察到的肿瘤免疫微环境也分为三种类型：炎症型、排斥型和冷型。多因素分析显示，FoxP 3 + T细胞减少和冷型肿瘤是预后不良的因素，而非SCC、治疗前肿瘤体积大和同时化疗3个或3个以下周期是预后不良的因素。冷型肿瘤的生存率明显低于其他两种类型，而炎症型和排除型肿瘤的5年疾病特异性生存率相似（P < 0.001; 0% vs. 60.3% vs. 72.3%）。放射治疗可以克服排斥型免疫微环境的抑制。适应于治疗前肿瘤免疫的个体化联合治疗可能是改善宫颈癌放射治疗结局的必要条件。
To supplement clinical decision-making in the management of cervical cancer, various prognostic factors, including tumor immune microenvironments, were examined in patients with cervical cancer treated with definitive chemoradiotherapy. We retrospectively analyzed the expression of CD8, FoxP3, HLA-1, PD-L1, and XRCC4 in 100 cases of cervical cancer. The observed tumor immune microenvironments were also classified into three types: inflamed, excluded, and cold type. Less FoxP3+ T cells and cold-type tumor were found to be poor prognostic factors in addition to non-SCC, large pre-treatment tumor volume, and three or less cycles of concurrent chemotherapy based on multivariate analysis. Cold-type tumors had significantly worse prognoses than the other two types, whereas inflamed- and excluded-type tumors showed similar 5-year disease-specific survival (P < 0.001; 0% vs. 60.3% vs. 72.3%). Radiotherapy could overcome the inhibitory immune microenvironment that occurs in excluded type. Individualized combination therapy adapted to pre-treatment tumor immunity may be necessary to improve radiotherapy outcomes in cervical cancer.