肿瘤间质比及肿瘤浸润性淋巴细胞对晚期结直肠癌的预后价值

Prognostic values of tumor-stroma ratio and tumor-infiltrating lymphocytes in stages Ⅱand Ⅲcolorectal cancer

  • 摘要: 目的:研究结直肠癌肿瘤间质比(tumor-stromaratio ,TSR )及肿瘤浸润性淋巴细胞(tumor-infiltratinglymphocytes,TIL)与结直肠癌患者的预后相关性。方法:收集浙江大学医学院附属第二医院病理科2007年1 月至2009年12月手术切除的原发性Ⅱ、Ⅲ期结直肠癌218 例病理资料进行回顾性分析,通过HE染色评估肿瘤组织中间质成分所占比例及淋巴细胞浸润情况,并分析不同分组对患者预后生存的影响。结果:218 例Ⅱ、Ⅲ期结直肠癌患者中低TSR 组总体生存率明显高于高间质组(P<0.05)。TSR 与各项临床特征及病理指标,如性别、年龄等无关(P>0.05)。TSR 及TIL 均为Ⅱ、Ⅲ期结直肠癌患者的独立预后因子。高淋巴细胞浸润组患者总体生存率明显高于低淋巴细胞浸润组患者,在低间质组中高淋巴细胞浸润组的患者总体生存率高于低淋巴细胞浸润组患者(P<0.05)。 结论:肿瘤间质比及肿瘤浸润性淋巴细胞对结直肠癌预后均相关,在常规病理诊断中通过对这两项指标的综合评估,可作为辅助指标对结直肠癌患者的预后预测、临床治疗选择提供依据。

     

    Abstract: Objective:To investigate the prognostic values of tumor–stroma ratio and tumor-infiltrating lymphocytes in colorec -tal cancer. Methods:A total of 218 stageⅡor  primary colorectal cancer patients were analyzed for the tumor–stroma ratio (TSR) and tumor-infiltrating lymphocytes (TIL) by using HE stained histological sections. The relationship between TSR and clinicopatholog -ic variables and the difference in clinical outcomes of different groups were also analyzed. Results: Overall survival rates for the stro-ma-low group were significantly higher than the stroma-high group in stages Ⅱand Ⅲcolorectal cancer (P<0.05). However, the differ -ences in TSR were not correlated with clinicopathologic features such as gender and age ( P>0.05). Overall survival rates of patients with high TIL were significantly higher than patients with low TIL ( P<0.05). Patients with high TIL had notable better prognosis than patients with low TIL (P<0.05) in the stroma-low group. Conclusion:TSR and TIL are independent prognostic factors for stages Ⅱand Ⅲcolorectal cancer. The combined estimates of TSR and TIL in routine pathology diagnoses may provide more evidence to predict the prognosis of stages Ⅱand Ⅲcolorectal cancer.

     

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