肿瘤出芽和TILs与结直肠癌患者临床病理特征和预后的相关性

目的:研究不同数量及比例的肿瘤出芽(tumor budding,TB)、肿瘤浸润淋巴细胞(tumor infiltrating lymphocytes,TILs)在结直肠癌中的临床病理意义。方法:收集193例结直肠癌患者的肿瘤切片和临床资料,在HE染色下观察肿瘤出芽及TILs水平,并分析肿瘤出芽、TILs、出芽TILs联合分组与患者临床病理特征和预后的关系。结果:在结直肠癌患者中,肿瘤出芽与TNM分期、肿瘤解剖分期、分化程度、脉管侵犯、神经侵犯和预后相关(P<0.05);TILs与性别、TNM分期、肿瘤解剖分期、分化程度、神经侵犯、伴黏液腺癌和预后相关(P<0.05);出芽TILs联合分组与TNM分期、肿瘤解剖分期、分化程度、脉管侵犯、神经侵犯和预后相关(P<0.05),低出芽+高TILs组总生存期最长,高出芽+高TILs组次之,低出芽+低TILs组再次之,高出芽+低TILs组总生存期最短;肿瘤浸润淋巴细胞水平与肿瘤出芽水平呈负相关。结论:不同水平的肿瘤出芽、TILs、出芽TILs联合分组均能反映结直肠癌侵袭转移能力及预后,且出芽TILs联合分组相比肿瘤出芽和TILs对预后有更精细的评估。

Correlation between tumor budding,TILs and clinicopathological features and prognosis of colorectal cancer patients

Objective:To investigate the clinicopathological significance of different number and proportion of tumor budding (TB) and tumor infiltrating lymphocytes (TILs) in colorectal cancer.Methods:Tumor tissue sections and clinical features of 193 colorectal cancer patients were selected,and the levels of tumor budding and TILs were observed under HE staining.The relationship between tumor budding,TILs,combined groups of budding and TILs and the clinicopathological characteristics and prognosis of patients was analyzed.Results:In patients with colorectal cancer,tumor budding was associated with TNM stage,tumor grade,differentiation degree,vascular invasion,perineural invasion and prognosis (P＜0.05).TILs were associated with gender,TNM stage,tumor grade,differentiation degree,perineural invasion,mucinous component and prognosis (P＜0.05).Combined groups of budding and TILs was associated with TNM stage,tumor grade,differentiation degree,vascular invasion,perineural invasion and prognosis (P＜0.05).Tumors with low budding+high TILs showed the longest overall survival,followed by cases with high budding+high TILs,followed by tumors with low budding+low TILs,and overall survival was worst for the high budding+low TILs group.The level of TILs was negatively correlated with the level of tumor budding.Conclusion:Different levels of tumor budding,TILs,and combined groups of budding and TILs all reflected the invasive metastatic ability and prognosis of colorectal cancer,and combined groups of budding and TILs are more relevant than tumor budding or TILs in terms of prognosis.