Background/Objectives: Adenocarcinomas of the esophagogastric and gastric areas are often managed with a multimodal treatment including neoadjuvant chemotherapy and surgery. The impact of neoadjuvant chemotherapy on the host’s antitumoral immune response remains largely unknown.Methods: A retrospective review of a single-institution cohort of patients with adenocarcinoma of the stomach or esophagogastric area undergoing curative intent surgery after neoadjuvant chemotherapy FLOT (Fluorouracil, Leucovorin, Oxaliplatin, Docetaxel) was reviewed. After institutional ethics approval, pathologic slides were re-reviewed and tumor-infiltrating lymphocyte scores were calculated. Tumor-infiltrating lymphocytes (TILs) were studied in conjunction with tumor regression scores (TRG) and the degree of regression in the involved lymph nodes as well as in correlation with the lymph node ratio (the ratio of involved lymph nodes over the total number of lymph nodes resected).Results: A total of 106 patients were reviewed. No statistical correlation could be established between the tumor-infiltrating lymphocyte scores and the degree of regression in the primary tumor as well as with the partial response to chemotherapy of pathologically involved lymph nodes. The TIL score also did not correlate with the lymph node ratio in our patient cohort. A strong correlation was noted between TILs and lymph nodes that completely regressed after neoadjuvant chemotherapy.Conclusions: Tumor-infiltrating lymphocytes do not correlate with the response of the primary tumor or the partial response of the involved lymph nodes, but only with the complete response to neoadjuvant chemotherapy of tumor-involved lymph nodes. Our study focuses on the effects of neoadjuvant chemotherapy on tumor-infiltrating lymphocytes compared to the effects on the primary tumor and the involved lymph nodes.
背景/目的：食管胃结合部及胃腺癌通常采用包括新辅助化疗和手术在内的多模式治疗。新辅助化疗对宿主抗肿瘤免疫反应的影响在很大程度上仍不明确。方法：回顾性分析单中心接受FLOT方案（氟尿嘧啶、亚叶酸钙、奥沙利铂、多西他赛）新辅助化疗后行根治性手术的胃或食管胃结合部腺癌患者队列。经机构伦理委员会批准后，重新审阅病理切片并计算肿瘤浸润淋巴细胞评分。将肿瘤浸润淋巴细胞（TILs）与肿瘤消退分级（TRG）、受累淋巴结消退程度以及淋巴结转移率（受累淋巴结数与切除淋巴结总数之比）进行关联分析。结果：共纳入106例患者。肿瘤浸润淋巴细胞评分与原发性肿瘤消退程度、病理阳性淋巴结对化疗的部分缓解均未显示出统计学相关性。在本研究队列中，TIL评分与淋巴结转移率亦无关联。但发现TILs与新辅助化疗后完全消退的淋巴结存在显著相关性。结论：肿瘤浸润淋巴细胞与原发性肿瘤的治疗反应或受累淋巴结的部分缓解无关，仅与肿瘤受累淋巴结对新辅助化疗的完全缓解相关。本研究重点关注新辅助化疗对肿瘤浸润淋巴细胞的影响，并与对原发性肿瘤及受累淋巴结的作用进行比较。
肿瘤(癌症)患者之家