Pretreatment tumour immune microenvironment predicts clinical response and prognosis of muscle-invasive bladder cancer in the neoadjuvant chemotherapy setting
Pretreatment tumour immune microenvironment predicts clinical response and prognosis of muscle-invasive bladder cancer in the neoadjuvant chemotherapy setting
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治疗前肿瘤免疫微环境可预测肌层浸润性膀胱癌在新辅助化疗背景下的临床反应和预后
DOI：
10.1038/s41416-021-01628-y
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发表时间：
2021-11-15
影响因子：
8.8
通讯作者：
Obara, Wataru
中科院分区：
文献类型：
--
作者：
Ikarashi, Daiki;Kitano, Shigehisa;Obara, Wataru
背景我们使用多重荧光免疫组织化学方法研究了cT 2 - 4aN 0 M0膀胱癌患者肿瘤微环境与新辅助化疗临床疗效之间的关系。方法回顾性分析51例cT 2 - 4aN 0 M0肌层浸润性膀胱癌新辅助化疗后行根治性膀胱切除术患者的临床资料。结果中位年龄为69岁，男性39例。pT 0、pT 1、pT 2和>= pT 3分别为12例（23.5%）、17例（33.3%）、10例（19.7%）和12例（23.5%）。应答者的5年癌症特异性生存率（96.6%）显著高于无应答者（48.4%; p = 0.0018）。无应答者肿瘤内区域的CD 8（+）T细胞（p = 0.0056）和CD 204（+）细胞（p = 0.0394）密度显著高于应答者。癌区CD 204（+）细胞密度高者预后差。结论对肌层浸润性膀胱癌标本免疫微环境的综合分析显示，预先存在的肿瘤浸润增殖性CD 8（+）T细胞和CD 204（+）细胞是新辅助化疗反应的指标，CD 204（+）细胞可被认为是这些患者的不利预后因素。
Background We examined the relationship between the tumour microenvironment and the clinical efficacy of neoadjuvant chemotherapy in patients with cT2-4aN0M0 bladder cancer using multiplex fluorescence immunohistochemistry. Methods The study retrospectively evaluated 51 patients who underwent radical cystectomy following neoadjuvant chemotherapy for cT2-4aN0M0 muscle-invasive bladder cancer. Patients were divided into responders ( Results The median age was 69 years; 39 patients were male. Twelve (23.5%), 17 (33.3%), 10 (19.7%) and 12 (23.5%) patients were pT0, pT1, pT2 and >= pT3, respectively. Responders had a significantly higher 5-year cancer-specific survival rate (96.6%) than non-responders (48.4%; p = 0.0018). CD8(+) T cell (p = 0.0056) and CD204(+) cell (p = 0.0394) densities were significantly higher in the intratumoural area in non-responders than in responders. Patients with higher CD204(+) cell densities in cancerous areas had worse prognosis. Conclusions This comprehensive analysis of the immune microenvironment of a muscle-invasive bladder cancer specimen revealed that preexisting tumour-infiltrating proliferating CD8(+) T cells and CD204(+) cells are indicators of the response to neoadjuvant chemotherapy and that CD204(+) cells can be considered an unfavourable prognostic factor in these patients.