Background/Objectives: Tumour-infiltrating lymphocytes (TILs) significantly influence the prognosis of epithelial ovarian cancer (EOC). Advanced EOCs often cause neutrophilia, ascites, and malnutrition. The neutrophil-to-lymphocyte ratio (NLR) serves as a marker of systemic inflammation. This study investigated the prognostic significance of pre-treatment NLR and TILs in advanced EOCs. Methods: Overall, 101 advanced EOCs (stages III–IV, FIGO 2014) were treated between 2005 and 2020. Based on pathological findings, advanced EOCs were classified as having high or low TILs using CD8 and CD4 immunostaining. The tumour proportion score was calculated to determine PD-L1 expression. The number of marker-positive cells was counted using HALO. Progression-free survival and overall survival (OS) were compared between the high- and low-NLR groups based on TILs levels. Results: Clinicopathological characteristics, including age, FIGO stage, histological subtype, and postoperative residual disease, did not significantly differ among the four groups defined by NLR and intra-epithelial CD8+ TILs (CD8+ iTILs). Multivariate analysis of OS revealed that NLR and CD8+ iTILs were independent prognostic factors, and no correlation was observed between them. The 5-year OS rates were 82.2% in the low NLR–high CD8+ iTILs group (n= 25), 41.7% in the low NLR–low CD8+ iTILs group (n= 16), 47.2% in the high NLR–high CD8+ iTILs group (n= 34), and 26.0% in the high NLR–low CD8+ iTILs group (n= 26). In the low-NLR subgroup, OS was significantly prolonged in the high CD8+ iTILs group (p= 0.023). Conclusions: In advanced EOCs, the status of tumour-localised immunity and pre-treatment systemic inflammation influenced long-term prognosis.
背景/目的：肿瘤浸润淋巴细胞（TILs）显著影响上皮性卵巢癌（EOC）的预后。晚期EOC常导致中性粒细胞增多、腹水和营养不良。中性粒细胞与淋巴细胞比值（NLR）是全身性炎症的标志物。本研究探讨了晚期EOC患者治疗前NLR和TILs的预后意义。方法：2005年至2020年间，共治疗了101例晚期EOC患者（III–IV期，FIGO 2014分期）。根据病理结果，通过CD8和CD4免疫组化染色将晚期EOC分为高TILs组和低TILs组。计算肿瘤比例评分以确定PD-L1表达水平。使用HALO软件计数标记阳性细胞数。根据TILs水平，比较高NLR组和低NLR组的无进展生存期和总生存期（OS）。结果：根据NLR和上皮内CD8+ TILs（CD8+ iTILs）水平划分的四组间，临床病理特征（包括年龄、FIGO分期、组织学亚型和术后残留病灶）无显著差异。OS的多变量分析显示，NLR和CD8+ iTILs是独立的预后因素，且两者之间未观察到相关性。低NLR–高CD8+ iTILs组（n=25）的5年OS率为82.2%，低NLR–低CD8+ iTILs组（n=16）为41.7%，高NLR–高CD8+ iTILs组（n=34）为47.2%，高NLR–低CD8+ iTILs组（n=26）为26.0%。在低NLR亚组中，高CD8+ iTILs组的OS显著延长（p=0.023）。结论：在晚期EOC中，肿瘤局部免疫状态和治疗前全身性炎症水平影响长期预后。
肿瘤(癌症)患者之家