Background: The immune contexture of solid tumors plays a critical role in cancer progression and response to immunotherapy. However, immunologic characterization of appendiceal cancer (AC) has lagged behind advancements in other gastrointestinal malignancies. This study aims to define the AC immune microenvironment by quantifying CD3+ and CD8+ lymphocyte densities and assessing their prognostic significance. Methods: Archival tissue samples from 95 AC patients were analyzed using immunohistochemistry to assess CD3+ and CD8+ T cell densities and their ratios. Associations between lymphocyte density and clinical, pathologic, and oncologic variables were examined using Spearman’s correlation, Kruskal–Wallis tests, and Cox proportional hazards analysis. Results: Tumor samples exhibited substantial immunologic heterogeneity with significant rightward skew. CD3+ and CD8+ densities were higher in low-grade tumors (p= 0.02 andp= 0.01, respectively) and low-grade histologic subtypes (p= 0.01 andp= 0.006). Lymphocyte density was inversely associated with patient age and was significantly lower in high-grade and non-mucinous tumors. The CD8+:CD3+ ratio emerged as an independent prognostic marker for progression-free survival (HR = 0.39,p= 0.004), whereas absolute CD3+ and CD8+ densities were less predictive. Conclusions: This study highlights the diverse immune microenvironment in AC, with immune infiltration patterns correlating with tumor grade and histologic subtype. The CD8+:CD3+ ratio is a potential prognostic biomarker for patient stratification, underscoring its clinical significance. Future studies should expand immune biomarker panels and explore immunomodulatory therapies for lymphocyte-rich AC subsets.
背景：实体瘤的免疫微环境在癌症进展及免疫治疗反应中起关键作用。然而，阑尾癌的免疫学特征研究滞后于其他胃肠道恶性肿瘤的进展。本研究旨在通过量化CD3+和CD8+淋巴细胞密度并评估其预后意义，明确阑尾癌的免疫微环境特征。 方法：采用免疫组织化学技术对95例阑尾癌患者的存档组织样本进行分析，评估CD3+和CD8+ T细胞密度及其比值。通过Spearman相关性分析、Kruskal-Wallis检验和Cox比例风险模型，探究淋巴细胞密度与临床、病理及肿瘤学变量之间的关联。 结果：肿瘤样本呈现显著的免疫异质性，分布呈明显右偏态。低级别肿瘤（p=0.02和p=0.01）及低级别组织学亚型（p=0.01和p=0.006）中CD3+和CD8+密度更高。淋巴细胞密度与患者年龄呈负相关，在高级别和非黏液性肿瘤中显著降低。CD8+:CD3+比值成为无进展生存期的独立预后标志物（HR=0.39，p=0.004），而绝对CD3+和CD8+密度的预测价值较低。 结论：本研究揭示了阑尾癌免疫微环境的多样性，免疫浸润模式与肿瘤分级和组织学亚型相关。CD8+:CD3+比值可作为患者分层的潜在预后生物标志物，具有重要临床意义。未来研究应扩展免疫生物标志物谱，并探索针对淋巴细胞富集型阑尾癌亚群的免疫调节疗法。
肿瘤(癌症)患者之家