TIL在胰腺导管腺癌患者术后肝转移和总生存时间的预测价值

Predictive value of TIL in postoperative hepatic metastasis and total survival time in patients with pancreatic ductal adenocarcinoma

目的探讨肿瘤间质淋巴细胞浸润(TIL)在PDAC患者行根治性切除后肝转移和总生存期中的预测价值。方法内蒙古医科大学赤峰临床医学院2010年7月—2015年12月共114例行根治性切除的PDAC患者纳入了研究。对PDAC患者术后病理组织切片常规进行HE染色,运用评分量表对肿瘤间质TIL密度进行评估。结果TIL-High(HR=0.403,95%CI 0.244~0.668,P<0.001)不仅是胰腺癌根治性切除术后OS良好的独立预测因素,同时也是术后发生肝转移(HR=0.371,95%CI 0.207~0.665,P=0.001)的独立预测因素。TIL密度与CEA(P=0.020),CA125(P=0.018)及肿瘤直径、T分期(P=0.047),淋巴结转移(P=0.020)成负相关。TIL-Low组患者CEA高(P=0.033),肿瘤直径大(P=0.028)。结论TIL对PDAC患者行根治术后的肝转移与总生存时间有潜在的预测作用,其或可为胰腺癌的治疗提供新的方向。

Objective To evaluate the predictive value of stromal tumor-infiltrating lymphocytes(TIL)for liver metastasis and overall survival in a PDAC(pancreatic ductal adenocarcinoma)patients with radical resection.Methods A total of 114 resectable patients with PDAC was enrolled in our study.Stromal TIL density were investigated using hematoxylin and eosin-stained sections from surgical specimens and evaluated by a scoring scale.Results Stromal TIL-High(HR=0.403,95%CI 0.244~0.668,P<0.001)is not only independent predictor of better OS,but also significant independent predictor for post-operative liver metastasis HR=0.371,95%CI 0.207~0.665,P=0.001.Higher level of CEA(0.033),bigger diameter(P=0.028)was associated with low stromal TIL density.And patients in stromal TIL-Low group tend to develop higher CEA(P=0.020),CA125(P=0.018),bigger diameter(P=0.028).Conclusions Our data suggests a potential role of stromal TIL for the prediction of liver metastasis and survival of patients with PDAC after radical resection which may service a promising treatment for PDAC in the future.