Assessing the Prognostic Value of Preoperative Carcinoembryonic Antigen-Specific T-Cell Responses in Colorectal Cancer
Assessing the Prognostic Value of Preoperative Carcinoembryonic Antigen-Specific T-Cell Responses in Colorectal Cancer
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DOI：
10.1093/jnci/djv001
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发表时间：
2015-04-01
影响因子：
10.3
通讯作者：
Godkin, Andrew
中科院分区：
文献类型：
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作者：
Scurr, Martin J.;Brown, Clare M.;Godkin, Andrew
目前的教条表明，肿瘤反应性IFN-γ产生（T（H）1型）T细胞对患者的预后有益;然而，这些反应对结直肠癌（CRC）长期预后的临床后果尚不清楚。在此，我们比较了术前、外周血来源的IFN-（γ +）T细胞对癌胚抗原（CEA）、5 T4或对照抗原（n = 64）的特异性反应与肿瘤分期和临床细节（n = 87）在预测结直肠癌根治性切除患者5年预后中的作用。尽管III期肿瘤患者更容易复发，但术前CEA特异性IFN-γ产生T细胞的存在表明，无论肿瘤分期如何，手术切除后肿瘤复发的风险在统计学上显著更高（比值比= 5.00，95%置信区间= 1.96至12.77，双侧P <0.001）。对其他抗原（包括5 T4）的反应并不能反映结果。虽然这些结果最初看起来令人惊讶，但它们可以改善辅助治疗并帮助重新定向辅助治疗。
Current dogma suggests that tumor-reactive IFN-gamma-producing (T(H)1-type) T-cells are beneficial to patient outcome; however, the clinical consequence of these responses with respect to long-term prognosis in colorectal cancer (CRC) is not understood. Here, we compared the utility of preoperative, peripheral blood-derived IFN-(gamma+) T-cell responses specific to carcinoembryonic antigen (CEA), 5T4, or control antigens (n = 64) with tumor staging and clinical details (n = 87) in predicting five-year outcome of CRC patients who underwent resection with curative intent. Although disease recurrence was more likely in patients with stage III tumors, the presence of preoperative, CEA-specific IFN-gamma-producing T-cells identified patients at a statistically significantly greater risk of tumor recurrence following surgical resection, irrespective of tumor stage (odds ratio = 5.00, 95% confidence interval = 1.96 to 12.77, two-sided P < .001). Responses to other antigens, including 5T4, did not reflect outcome. Whilst these results initially appear surprising, they could improve prognostication and help redirect adjuvant treatments.