中国全科医学 ›› 2023, Vol. 26 ›› Issue (32): 4038-4042.DOI: 10.12114/j.issn.1007-9572.2023.0112

• 论著 • 上一篇    下一篇

肿瘤出芽及肿瘤浸润淋巴细胞对食管鳞状细胞癌淋巴结转移的预测价值研究

张继方1, 陈芳1, 唐佳雯1, 李红亮2,*()   

  1. 1.315040 浙江省宁波市,宁波大学附属人民医院病理科
    2.315040 浙江省宁波市,宁波大学附属人民医院消化内科
  • 收稿日期:2023-02-21 修回日期:2023-04-08 出版日期:2023-11-15 发布日期:2023-05-04
  • 通讯作者: 李红亮

  • 作者贡献:张继方提出主要研究目标,负责研究的构思与设计,研究的实施,统计学处理,图、表的绘制与展示,撰写论文;唐佳雯进行数据的收集与整理;张继方、陈芳负责病理形态学评估,进行论文的修订;李红亮负责文章的质量控制与审查,对文章整体负责,监督管理。
  • 基金资助:
    浙江省卫生健康科技计划(2022KY1182)

Predictive Value of Tumor Budding and Tumor-infiltrating Lymphocytes on Lymph Node Metastasis of Esophageal Squamous Cell Carcinoma

ZHANG Jifang1, CHEN Fang1, TANG Jiawen1, LI Hongliang2,*()   

  1. 1. Department of Pathology, the Affiliated People's Hospital of Ningbo University, Ningbo 315040, China
    2. Department of Gastroenterology, the Affiliated People's Hospital of Ningbo University, Ningbo 315040, China
  • Received:2023-02-21 Revised:2023-04-08 Published:2023-11-15 Online:2023-05-04
  • Contact: LI Hongliang

摘要: 背景 食管癌淋巴结转移状态影响患者的手术方案和预后情况,需要寻找能够预测食管癌淋巴结转移的危险因素,从而协助临床诊疗。 目的 探讨肿瘤出芽(TB)、肿瘤浸润淋巴细胞(TILs)预测食管鳞状细胞癌患者淋巴结转移的价值。 方法 选择2013年1月—2022年3月于宁波大学附属人民医院行食管癌根治切除并留存石蜡标本的124例食管鳞状细胞癌患者为研究对象,采用光镜和细胞角蛋白(CK)5/6免疫组织化学染色评估患者癌组织中TB分级及TILs密度,采用多因素Logistic回归分析探究食管鳞状细胞癌患者淋巴结转移的影响因素,并采用受试者工作特征(ROC)曲线探讨TB和TILs对食管鳞状细胞癌患者淋巴结转移的预测价值。 结果 多因素Logistic回归分析结果显示TB〔OR=20.078,95%CI(6.043,66.713),P<0.001〕)、TILs〔OR=0.218,95%CI(0.071,0.666),P=0.008〕、脉管内癌栓〔OR=28.609,95%CI(7.512,108.946),P<0.001〕是食管鳞状细胞癌患者淋巴结转移的影响因素。TB分级预测食管鳞状细胞癌患者淋巴结转移的ROC曲线下面积(AUC)为0.835〔95%CI(0.763,0.907)〕,TILs密度预测食管鳞状细胞癌患者淋巴结转移的AUC为0.656〔95%CI(0.558,0.753)〕。 结论 TB、TILs为食管鳞状细胞癌患者淋巴结转移的影响因素,TB分级与TILs密度对食管鳞状细胞癌患者淋巴结转移有较好的预测效能。

关键词: 食管鳞状细胞癌, 食管肿瘤, 肿瘤出芽, 肿瘤浸润淋巴细胞, 淋巴转移, Logistic模型, 预测

Abstract:

Background

The surgical protocols and prognosis of esophageal squamous cell carcinoma (ESCC) patients influenced by the status of lymph node metastasis. It is necessary to identify risk factors that can predict lymph node metastasis to assist in clinical treatment.

Objective

To investigate the predict value of tumor budding (TB) and tumor-infiltrating lymphocytes (TILs) on lymph node metastasis (LNM) in patients with ESCC.

Methods

A total of 124 patients with ESCC who underwent radical resection and retained paraffin-embedded specimens in the Affiliated People's Hospital of Ningbo University from January 2013 to March 2022 were selected as the research subjects. The light microscopy and CK5/6 immunohistochemical staining were used to evaluate the amount of TB and density of TILs. Multivariate Logistic regression analysis was used to explore the influencing factors of lymph node metastasis in patients with ESCC and the receiver operating characteristic (ROC) curve was plotted to investigate the predictive value of TB and TILs for lymph node metastasis in patients with ESCC.

Results

Multivariate Logistic regression analysis showed that TB〔OR=20.078, 95%CI (6.043, 66.713), P<0.001〕, TILs〔OR=0.218, 95%CI (0.071, 0.666), P=0.008〕and intravascular tumor thrombus〔OR=28.609, 95%CI (7.512, 108.946), P<0.001〕 were influencing factors for lymph node metastasis. The area under ROC curve (AUC) for TB and TILs to predict lymph node metastasis in patients with ESCC was 0.835〔95%CI (0.763, 0.907) 〕 and 0.656〔95%CI (0.558, 0.753) 〕, respectively.

Conclusion

High-grade TB and low-density TILs were influencing factors for lymph node metastasis, TB grade and density of TILs has good diagnostic efficacy in predicting lymph node metastasis in patients with ESCC.

Key words: Esophageal squamous cell carcinoma, Esophageal neoplasms, Tumor budding, Tumor-infiltrating lymphocytes, Lymph metastasis, Logistic models, Forecasting