间质肿瘤浸润淋巴细胞与淋巴细胞活化基因3在进展期胃腺癌中的预后价值  

Prognostic values of stromal tumor-infiltrating lymphocytes and lymphocyte-activation gene-3 in advanced gastric adenocarcinoma

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作  者:吴志达 王健超 张和军[1] 林洁琼[1] 吴在增 郑雄伟[1] 陈刚[1] Wu Zhida;Wang Jianchao;Zhang Hejun;Lin Jieqiong;Wu Zaizeng;Zheng Xiongwei;Chen Gang(Department of Pathology,Fujian Medical University Cancer Hospital,Fujian Cancer Hospital,Fuzhou 350014,China)

机构地区:[1]福建医科大学附属肿瘤医院福建省肿瘤医院病理科,福州350014

出  处:《中华病理学杂志》2022年第10期1007-1012,共6页Chinese Journal of Pathology

基  金:福建省科技厅计划资助项目(2019YZ016006);福建省卫健委科技计划项目(2020GGB009)。

摘  要:目的探讨间质肿瘤浸润淋巴细胞(stromal tumor-infiltrating lymphocytes,sTIL)及淋巴细胞活化基因3(lymphocyte-activation gene-3,LAG-3)与进展期胃腺癌临床病理特征及预后的相关性。方法福建省肿瘤医院2011年1月至2014年12月进展期胃腺癌病例260例,收集患者的临床病理资料及随访资料,使用半定量的方法对胃癌切片中sTIL的百分比进行计算,并用免疫组织化学对LAG-3蛋白进行检测,探究sTIL、LAG-3与进展期胃腺癌患者预后的相关性。结果260例进展期胃腺癌中sTIL高浸润173例(66.5%),LAG-3高表达160例(61.5%)。同时,本研究根据sTIL浸润情况与LAG-3的表达情况将本组病例分成4组。Ⅰ组:sTIL低浸润/LAG-3低表达48例(18.5%);Ⅱ组:sTIL高浸润/LAG-3低表达52例(20.0%);Ⅲ组:sTIL低浸润/LAG-3高表达39例(15.0%);Ⅳ组:sTIL高浸润/LAG-3高表达121例(46.5%)。Kaplan-Meier单因素分析结果显示,胃腺癌患者的预后与年龄、肿物大小、肿瘤位置、Lauren分型、神经侵犯、脉管癌栓、TNM分期、术后辅助化疗、分子分型存在相关性(P<0.05),且sTIL高浸润、LAG-3高表达患者预后较好。多因素Cox分析结果显示,年龄、肿物大小、Lauren分型、术后辅助化疗是进展期胃腺癌患者的独立预后因素,且sTIL低浸润/LAG-3低表达进展期胃腺癌患者预后较差。结论sTIL、LAG-3与进展期胃腺癌患者预后呈正相关。sTIL与LAG-3联合使用可以更准确地预测进展期胃腺癌患者的预后。年龄、肿物大小、Lauren分型、术后辅助化疗是进展期胃腺癌患者的独立预后因素。Objective To analyze density of stromal tumor-infiltrating lymphocytes(sTIL)and expression of lymphocyte-activation gene-3(LAG-3)protein in advanced gastric adenocarcinomas,and to investigate the correlation of sTIL and LAG-3 with the prognosis in patients with advanced gastric adenocarcinoma.Methods The clinicopathological characteristics and follow-up data of 260 patients with advanced gastric adenocarcinoma were collected at Fujian Cancer Hospital,from January 2011 to December 2014.The percentage of sTILs was reported semi-quantitatively using histological section evaluation,the LAG-3 protein was detected using immunohistochemistry,and the expression was correlated with the clinicopathological features and patient outcomes.Results Among the 260 cases,high density of sTIL was detected in 173 cases(66.5%)while LAG-3 high expression was observed in 160 cases(61.5%).These cases were divided into four groups.GroupⅠ:48 cases(18.5%)were sTIL low/LAG-3 low;groupⅡ:52 cases(20.0%)were sTIL high/LAG-3 low;groupⅢ:39 cases(15.0%)were sTIL low/LAG-3 high;groupⅣ:121 cases(46.5%)were sTIL high/LAG-3 high.Kaplan-Meier survival analyses showed that patient prognoses were related to age,tumor size,tumor location,Lauren classification,perineural invasion,vascular invasion,TNM staging,postoperative adjuvant chemotherapy and molecular classification(P<0.05).Meanwhile,higher densities of sTIL and higher expression of LAG-3 were associated with better prognosis.Multivariate survival analysis showed age,tumor size,Lauren classification and postoperative adjuvant chemotherapy were independent prognostic factors for patient survival.The results showed a poor prognosis in low-sTIL/low-LAG-3 patients.Conclusions Compared with low density of sTIL and low expression of LAG-3,high density of sTIL and high expression of LAG-3 are associated with better outcomes in patients with advanced gastric adenocarcinoma,respectively.Combined detecton of sTIL and LAG-3 may be more useful in gastric cancer than using either alone.Age,tumor size,La

关 键 词:胃肿瘤 腺癌 预后 淋巴细胞活化 肿瘤浸润淋巴细胞 

分 类 号:R735.2[医药卫生—肿瘤]

 

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