食管鳞状细胞癌组织中FGL1的表达、肿瘤浸润淋巴细胞的分布及其意义

目的 探讨食管鳞状细胞癌（ESCC）组织中纤维蛋白原样蛋白1（FGL1）的表达、肿瘤浸润淋巴细胞（TILs）的分布及其与预后的关系。方法 回顾性分析120例ESCC患者临床资料，采用免疫组织化学法检测FGL1的表达，HE镜下评估肿瘤内浸润淋巴细胞（iTILs）和肿瘤间质浸润淋巴细胞（sTILs）的分布情况。生存分析评估患者的预后情况。结果 FGL1在ESCC组织中的阳性率为18.3%（22/120），其表达与TNM分期、淋巴结转移和TILs有关；ESCC组织中低度iTILs（iTILs≤10%）73例（60.8%），高度iTILs（iTILs>10%）47例（39.2%）；低度sTILs（sTILs≤10%）82例（68.3%），高度sTILs（sTILs>10%）38例（31.7%）。iTILs分布与FGL1的表达、肿瘤分化程度和TNM分期有关，sTILs分布与FGL1的表达、肿瘤部位和TNM分期有关。Kaplan-Meier生存分析结果显示肿瘤直径、TNM分期、淋巴结转移、FGL1的表达、TILs的分布与患者预后有关（P<0.05），多因素Cox回归结果显示，FGL1的表达、TILs的分布和TNM分期是患者预后的影响因素。结论 FGL1的表达与ESCC的不良预后相关，可能成为ESCC的预后生物标志物。FGL1联合TILs可作为预测ESCC预后的生物标志物。

Expression of FGL1, Distribution of Tumor-Infiltrating Lymphocytes,and Their Clinical Significance in Esophageal Squamous-Cell Carcinoma

Objective To explore the expression of fibrinogen-like protein 1 (FGL1), the distribution of tumor-infiltrating lymphocytes (TILs), and their relationship with the prognosis of esophageal squamous-cell carcinoma (ESCC) patients. Methods We analyzed retrospectively the clinical data of 120 ESCC patients. The expression of FGL1 was detected through immunohistochemistry. The distributions of intratumoral TILs (iTILs) and stromal TILs (sTILs) were evaluated under a microscope. Survival analysis was used to evaluate the patient outcomes. Results The positive rate of FGL1 in ESCC was 18.3% (22/120), and it was connected to the TNM stage, lymph node status, and TILs. A total of 73 cases (60.8%) showed low levels of iTILs (iTILs≤10%), and 47 cases (39.2%) exhibited high iTIL levels (iTILs>10%). Similarly, 82 cases (68.3%) presented low levels of sTILs (sTILs≤10%), and 38 cases (31.7%) manifested high sTIL levels (sTILs>10%). The distribution of iTILs was associated with FGL1, tumor differentiation, and TNM stage, whereas the distribution of sTILs was associated with FGL1, tumor location, and TNM stage. The Kaplan–Meier survival analysis showed that tumor diameter, TNM stage, lymph node status, FGL1, and TILs were associated with the prognosis of patients with ESCC (P<0.05). Multivariate Cox regression revealed that FGL1, TILs and TNM stage were the influencing factors of prognosis. Conclusion FGL1 expression is associated with the poor prognosis and may be a prognostic biomarker of ESCC. FGL1 combined with TILs can be used as a biomarker to predict ESCC.