Background:Immunotherapy has significantly improved overall survival in patients with pleural mesothelioma, yet this benefit does not extend to those with the epithelioid subtype. Tumor growth is believed to be influenced by the immune response. This study aimed to analyze the tumor microenvironment to gain a better understanding of its influence on tumor growth.Methods:The tumor immune cell infiltration of 188 patients with pleural mesothelioma was characterized by multiplex immunofluorescence staining for CD3+ cells (CD3+), CD4+ cells (CD3+/CD4+), CD8+ cells (CD3+/CD8+), Treg (CD3+/CD4+/CD8-/CD163-/Foxp3+), PD1 cells (PD1+), and T helper cells (CD3+/CD4+/CD8-/CD163-/FoxP3-). The distribution of specific immune cells was correlated with clinical parameters.Results:A total of 188 patients with pleural mesothelioma (135 epithelioid, 9 sarcomatoid, 44 biphasic subtypes) were analyzed. The median age was 64.8 years. Overall survival was significantly longer in the epithelioid subtype than in the non-epithelioid subtype (p= 0.016). The presence of PD-L1 expression had a negative effect on overall survival (p= 0.041). A high ratio of CD4+ cells to regulatory T cells was associated with a significantly longer overall survival of more than 12 months (p= 0.015). The ratio of CD4+ cells to regulatory T cells retained its significant effect on overall survival in the multivariate analysis.Conclusions:Distinct differences in the T cell immune infiltrates in mesothelioma are strongly associated with overall survival. The tumor microenvironment could therefore serve as a source of prognostic biomarkers.
背景：免疫疗法已显著提高胸膜间皮瘤患者的总生存期，但这一获益并未延伸至上皮样亚型患者。肿瘤生长被认为受免疫反应影响。本研究旨在通过分析肿瘤微环境，以更深入理解其对肿瘤生长的影响。 方法：采用多重免疫荧光染色技术对188例胸膜间皮瘤患者的肿瘤免疫细胞浸润特征进行分析，检测指标包括CD3+细胞、CD4+细胞、CD8+细胞、调节性T细胞、PD1细胞及辅助性T细胞。特定免疫细胞分布情况与临床参数进行关联分析。 结果：共分析188例胸膜间皮瘤患者（上皮样亚型135例，肉瘤样亚型9例，双相型亚型44例），中位年龄64.8岁。上皮样亚型患者总生存期显著长于非上皮样亚型（p=0.016）。PD-L1表达阳性对总生存期产生负面影响（p=0.041）。CD4+细胞与调节性T细胞的高比值与超过12个月的显著延长总生存期相关（p=0.015）。在多变量分析中，CD4+细胞与调节性T细胞的比值对总生存期仍保持显著影响。 结论：间皮瘤中T细胞免疫浸润的显著差异与总生存期密切相关。肿瘤微环境可作为预后生物标志物的来源。
肿瘤(癌症)患者之家