転移性大腸癌における原発巣切除による免疫状態変化と予後に関する検討

转移性结直肠癌原发灶切除引起的免疫状态变化及预后研究

• 批准号: 18K16294
• 负责人: 市川 伸樹
• 金额: $ 2.66万
• 依托单位: Hokkaido University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Early-Career Scientists
• 财政年份: 2018
• 资助国家: 日本
• 起止时间: 2018-04-01 至 2024-03-31
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/en/grant/KAKENHI-PROJECT-18K16294/
• 关键词: リンパ球単球比; 切除不能大腸癌; 姑息的切除; 転移性大腸癌; 大腸癌; 切除; 予後; マクロファージ; リンパ球; 腫瘍免疫

切除不能転移性大腸癌において、末梢血中リンパ球/単球比（LMR）は生命予後と関連するとされる。また、血中の免疫細胞の組成は、腫瘍局所での免疫状態を反映するとも報告される。今回、遠隔転移を有する切除不能転移性大腸癌における原発巣切除の意義を見いだす事を目的とし、切除により免疫細胞の組成が好転する集団では生命予後改善の意義があるのではないかと考えた。切除不能転移性大腸癌の原発巣切除によりLMRの術後増加する症例は減少する症例よりは生命予後が良い可能性を考え、切除後にLMRが増加する症例と減少する症例を比較し、免疫状態変化と予後与える影響を検討した。結果、切除不能転移性大腸癌において、64例の原発切除症例を59例の非切除症例を比較し、原発切除症例で予後が良い事が示された。また、両群では背景因子に差を認めるものの、Cox回帰による予後因子解析でも原発非切除は独立因子となっていた。さらに、原発切除症例でLMRの変化に注目して評価を追加すると、LMRの術後増加症例は減少症例では背景因子に差を認めず、増加症例は減少症例に比較して有意に予後が良い事が見いだされた（生存期間中央値27.3対20.8ヶ月）。LMR増加例と減少例で、切除検体を比較すると、増加例では有意にCD8+リンパ球/CD163+単球比が低い事が見いだされ、別コホートでの追試でも同様の組織検体での特徴が見られた。この結果をSurgery Today誌へ投稿しpublishとなった。その後、LMRの術後増加症例と減少症例の臨床病理学的特徴を術前に予見するバイオマーカーを見出すべく、研究を継続している。

Resection of unmetastatic colorectal cancer is associated with peripheral blood mass ratio (LMR). The composition of immune cells in the blood reflects the immune status of the tumor. The purpose of excision and the composition of immune cells are important for improving the quality of life. The number of patients with unresectable colorectal cancer increased after resection, and the number of patients with unresectable colorectal cancer decreased after resection. Results: 64 cases of resectable colorectal cancer were compared with 59 cases of non-resectable colorectal cancer. The analysis of the background factor of the group is based on the analysis of the background factor. In addition, the number of LMR patients who underwent primary resection was increased, and the number of LMR patients who underwent postoperative resection was decreased. In addition, the number of LMR patients who underwent postoperative resection was increased, and the number of LMR patients who underwent postoperative resection was decreased. In addition, the number of LMR patients who underwent postoperative resection was increased, and the number of LMR patients who underwent postoperative resection was decreased. In addition, the number of LMR patients who underwent postoperative resection was increased, and the number of LMR patients who underwent postoperative resection was decreased, and the number of LMR patients who underwent postoperative resection was increased, and the number of LMR patients who underwent postoperative resection was decreased, was increased, and the number of LMR patients who underwent postoperative resection was decreased, was increased, and the number of LMR patients who underwent postoperative resection was decreased, was increased, and the number of LMR patients who underwent postoperative resection was decreased, was increased, and the number of LMR patients who underwent postoperative resection was increased, and the number of LMR patients who underwent postoperative resection was decreased, was increased, and the number of LMR patients who underwent postoperative resection was increased, and the number LMR increases, decreases, resections, and increases in the CD8 +/CD163 + ratio. The results of surgery today will be published. The increase in the number of cases after surgery and the decrease in the clinical pathology characteristics of cases were observed before surgery.

项目成果

Impact of Primary Tumor Resection in Colorectal Cancer with Unresectable Metastasis.

原发肿瘤切除术对无法切除转移的结直肠癌的影响。

• 发表时间: 2019
• 作者: Nobuki Ichikawa;Shigenori Homma;Tadashi Yoshida;Futoshi;Kawamata;Tomoko Mitsuhashi;Hiroaki Iijima;Susumu Shibasaki;Hideki Kawamura;Kazuhiro Ogasawara;Keizo Kazui;You Kamiizumi;Akinobu Taketomi
• 通讯作者: Akinobu Taketomi

Increase of peripheral lymphocyte-monocyte ratio after the primary site resections related with the prolonged survival in unresectable colorectal carcinoma

原发部位切除后外周淋巴细胞-单核细胞比率的增加与不可切除结直肠癌的延长生存期相关

• 发表时间: 2018
• 作者: Nobuki Ichikawa;Shigenori Homma;Tadashi Yoshida;Futoshi;Kawamata;Tomoko Mitsuhashi;Hiroaki Iijima;Susumu Shibasaki;Hideki Kawamura;Kazuhiro Ogasawara;Keizo Kazui;You Kamiizumi;Akinobu Taketomi;Nobuki Ichikawa;Nobuki Ichikawa
• 通讯作者: Nobuki Ichikawa

切除不能転移性大腸癌における原発巣切除の意義の検討

探讨原发肿瘤切除对于不可切除的转移性结直肠癌的意义

• 发表时间: 2018
• 作者: Nobuki Ichikawa;Shigenori Homma;Tadashi Yoshida;Futoshi;Kawamata;Tomoko Mitsuhashi;Hiroaki Iijima;Susumu Shibasaki;Hideki Kawamura;Kazuhiro Ogasawara;Keizo Kazui;You Kamiizumi;Akinobu Taketomi;Nobuki Ichikawa;Nobuki Ichikawa;市川伸樹
• 通讯作者: 市川伸樹