肿瘤浸润淋巴细胞在胆管癌中的作用

Role of tumor-infiltrating lymphocytes in cholangiocarcinoma

胆管癌(cholangiocarcinoma,CCA)是最常见的原发于胆道系统的恶性上皮性肿瘤,由于缺乏系统有效的治疗,通常生存率较低,预后较差。作为肿瘤微环境(tumor microenvironment,TME)重要的一类免疫细胞,肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TILs)是人体进行免疫应答的重要组成成分,深入了解CCA的TME中TILs与肿瘤细胞的相互作用,对肿瘤免疫治疗效果和预后具有重要意义。CCA不同的病理学亚型在生物学行为及临床预后方面存在差异,同时TILs的组成、分布、时空表达特点也会影响患者免疫治疗效果及预后。在CCA中,CD8^(+)T和CD4^(+)T淋巴细胞大多隔离在肿瘤周围,CD20^(+)B淋巴细胞和自然杀伤(natural killer,NK)细胞数量较少。浸润在肿瘤中的调节性T细胞(regulatory T cells,Tregs)通常与免疫逃逸相关。进一步全面分析CCA各个病理学亚型中的TILs在肿瘤内部、浸润边缘、肿瘤周边等区域的表达规律,有助于探究基于CCA病理分型的相关免疫治疗。TILs评估方式有多种,基于CCA的苏木精-伊红(hematoxylin-eosin,HE)染色切片进行TILs的标准化半定量评估可适用于大规模临床试验以及日常病理实践。对CCA中TILs进行研究将为CCA免疫治疗及TME的进一步探究提供重要参考。

Cholangiocarcinoma(CCA)is the most common primary malignant epithelial tumor originating in the biliary system.Due to the lack of effective systemic treatment,the survival rates are generally low with poor prognosis.As a crucial category of immune cells in the tumor microenvironment(TME),tumor-infiltrating lymphocytes(TILs)are vital components of the human immune response.In-depth understanding of the interactions between TILs and tumor cells in TME of CCA is of great significance for the effectiveness of tumor immunotherapy and prognosis.Various pathological subtypes of CCA exhibit biological and clinical differences,and the composition,distribution,and spatiotemporal expression characteristics of TILs also affect the immunotherapy effect and prognosis of patients.In CCA,CD8^(+)T and CD4^(+)T lymphocytes are mostly isolated around the tumor,and CD20^(+)B lymphocytes and natural killer(NK)cells are less numerous.The infiltration of regulatory T cells(Tregs)in the tumor is often associated with immune escape.Analysis of the expression patterns of TILs in various pathological subtypes of CCA within the tumor,at the invasive margin,and around the tumor with each pathological subtype,which is helpful to explore relevant immunotherapies for CCA.There are various methods for TILs evaluation,and standardized semi-quantitative assessment of TILs based on hematoxylin-eosin(HE)staining of CCA tissue sections can be applied for large-scale clinical trials as well as routine pathology practice.The study on TILs in CCA will provide an important reference for further investigations for CCA immunotherapy and TME.