Prognostic significance of lymphocyte infiltration following preoperative chemoradiotherapy and hyperthermia for esophageal cancer
Prognostic significance of lymphocyte infiltration following preoperative chemoradiotherapy and hyperthermia for esophageal cancer
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DOI：
10.1016/s0360-3016(00)01465-6
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发表时间：
2001-04-01
影响因子：
7
通讯作者：
Sugimachi, K
中科院分区：
文献类型：
--
作者：
Morita, M;Kuwano, H;Sugimachi, K
目的：癌灶周围淋巴细胞浸润（LI）是一种重要的免疫反应。本研究的目的是评估LI在食管癌术前治疗后的预后意义。术前放化疗51例食管癌采用CR治疗，即博莱霉素30 mg或顺铂120 mg/m2加放疗30戈伊，同时采用温热放化疗71例同时接受HCR治疗，并对手术切除的肿瘤组织进行病理组织学观察，评价肿瘤组织的LI程度。LI（-）组和LI（++）组术前治疗有效率分别为56%和92.3%（P < 0.05）。有LI者预后良好，LI（++）和LI（+）患者的5年生存率分别为75.5%和46.1%，均明显优于LI（-）患者的27.8%（分别为P < 0.05和P < 0.01）。特别是在术前治疗中度有效的病例中，多变量分析显示LI是独立于其他临床病理因素的有利预后因素（p = 0.0171）。在术前治疗方面，HCR组LI（++）的发生率（16.9%）高于CR组（2.0%，p < 0.01）。结论：LI可能是术前CR治疗后的一个预后预测因素，同时热疗可刺激LI。(C)2001 Elsevier Science Inc.
Purpose: Lymphocyte infiltration (LI) around cancerous lesions is an important immune response. The purpose of this study is to evaluate the prognostic significance of LI after preoperative treatment for esophageal cancer.Methods and Materials: Preoperative chemoradiotherapy (CR therapy), either bleomycin 30 mg or cisplatin 120 mg/m(2) plus radiation 30 Gy, was performed on 51 cases with esophageal cancer, while hyperthermo-chemoradiotherapy (HCR therapy) was also indicated in 71 cases, Using resected specimens, both the histopathologic effectiveness and degree of LI to cancerous lesions were evaluated.Results: The incidences of the cases in which preoperative treatment was effective were 56% and 92.3% in LI (-) and LI (++) group (p < 0.05). The presence of LI resulted in favorable prognosis; the 5-year survival rates of LI (++) and LI (+) patients were 75.5% and 46.1%, both of which were significantly better than LI (-) (27.8%, p < 0.05 and p < 0.01, respectively). Especially among cases whose preoperative treatment was moderately effective, a multivariate analysis revealed LI to be a favorable prognostic factor independent of other clinicopathologic factors (p = 0.0171). Regarding the preoperative treatment, the incidence of LI (++) was higher in the HCR group (16.9%) than in the CR group (2.0%,p < 0.01).Conclusions: LI appears to be a prognostic predictor after preoperative CR therapy while, in addition, simultaneous hyperthermia may stimulate LI in cases with esophageal cancer. (C) 2001 Elsevier Science Inc.