中国口腔颌面外科杂志

中国口腔颌面外科杂志 ›› 2024, Vol. 22 ›› Issue (6): 541-546.doi: 10.19438/j.cjoms.2024.06.004

• 论著 • 上一篇    下一篇

三级淋巴结构与头颈部鳞癌临床病理特征及预后的相关性分析

薛俊青, 张莺, 胡宇华, 李江, 夏荣辉   

  1. 上海交通大学医学院附属第九人民医院 口腔病理科,上海交通大学口腔医学院,国家口腔医学中心, 国家口腔疾病临床医学研究中心,上海市口腔医学重点实验室,上海市口腔医学研究所,上海 200011
  • 收稿日期:2024-04-27 修回日期:2024-06-01 出版日期:2024-11-20 发布日期:2024-12-11
  • 通讯作者: 夏荣辉,E-mail: xrh335@163.com
  • 作者简介:薛俊青（1993-）,男,本科,技师,E-mail: 253252317@qq.com
  • 基金资助:
    国家自然科学基金面上项目（82373325,82273017）; 上海市卫生健康委员会卫生行业临床研究专项（202340101）; 上海科技大学交叉研究基金项目（JYJC202121）

Study on the correlation between tertiary lymphoid structure and clinical pathological characteristics and prognosis of head and neck squamous cell carcinoma

XUE Jun-qing, ZHANG Ying, HU Yu-hua, LI Jiang, XIA Rong-hui   

  1. Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology; Shanghai Research Institute of Stomatology.Shanghai 200011, China
  • Received:2024-04-27 Revised:2024-06-01 Online:2024-11-20 Published:2024-12-11

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摘要： 目的： 探讨头颈部鳞癌（head and neck squamous cell carcinoma,HNSCC）中三级淋巴结构（tertiary lymphoid structure,TLS）与临床病理特征、肿瘤程序性死亡配体（programmed death ligand 1,PD-L1）表达、CD8阳性浸润细胞数及患者预后的关系。方法： 选择2017年5月—2022年9月于上海交通大学医学院附属第九人民医院口腔病理科诊断为HNSCC的患者72例。采用免疫组织化学方法检测肿瘤组织中CD20、CD3、CD21、PNAd、PD-L1和CD8表达。通过综合阳性评分,评估PD-L1表达水平;通过Caseviewer软件,计算CD8阳性细胞的浸润度和浸润比例。采用SPSS 25.0软件包统计分析TLS状态与临床病理特征、PD-L1表达、肿瘤免疫微环境和患者预后的相关性。结果： 72例HNSCC患者中,TLS阳性率为41.7%（30/72）。年龄<58岁的患者,TLS阳性率显著高于≥58岁的患者（P=0.004）,TLS状态与其他临床病理特征均无显著相关性。PD-L1高表达组,TLS阳性率显著高于PD-L1低表达组（60.7%∶29.5%,P=0.014）。TLS阳性HNSCC病例的CD8阳性细胞浸润度和浸润比例,显著高于TLS阴性HNSCC病例。PD-L1高表达组和TLS阳性患者具有更高的总生存率。结论： HNSCC中,TLS阳性率与PD-L1表达、CD8阳性细胞浸润度和浸润比例呈显著正相关,且TLS阳性组患者预后显著优于TLS阴性组患者,提示TLS与HNSCC肿瘤免疫微环境、肿瘤免疫治疗和患者预后关系密切。

关键词: 三级淋巴结构, 头颈部鳞癌, 临床病理特征, 免疫治疗, 肿瘤微环境, 预后

Abstract: PURPOSE: To explore the relationship between tertiary lymphoid structure(TLS) and clinicopathological characteristics, programmed death ligand 1(PD-L1), CD8 positive infiltrating cells, and prognosis in head and neck squamous cell carcinoma(HNSCC). METHODS: A total of 72 patients diagnosed with HNSCC in the Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine from May 2017 to September 2022 were enrolled in this study. The expressions of CD20, CD3, CD21, PNAd, PD-L1 and CD8 in tumor tissues were detected by immunohistochemistry, and combined positive score(CPS) was used to evaluated the PD-L1 expression level. The Caseviewer software was used to calculate the infiltration degree and proportion of CD8 positively staining cells. Statistical analysis of the correlation between TLS status and clinicopathological characteristics, PD-L1 expression, tumor immune microenvironment, and prognosis was performed using SPSS 25.0 software package. RESULTS: Of the 72 patients with HNSCC, TLS positive rate was 41.7% (30/72). The TLS positive rate in patients <58 years old was significantly higher than that in patients ≥58 years old (P=0.004). There was no significant correlation between TLS status and other clinicopathological characteristics. The positive rate of TLS in the PD-L1 high expression group was significantly higher than that in the PD-L1 low expression group (60.7% vs. 29.5%, P=0.014). The infiltration degree and proportion of CD8 positive cells in TLS positive HNSCC cases are significantly higher than those in TLS negative HNSCC cases. The PD-L1 high expression group and TLS positive patients have a higher overall survival rate. CONCLUSIONS: TLS structure is significantly positively correlated with PD-L1 expression, CD8 positive cell infiltration degree, and infiltration proportion in HNSCC. Patients in the TLS positive group had a significantly better prognosis than those in the TLS negative group, indicating a close relationship between TLS and the tumor immune microenvironment, tumor immunotherapy response, and prognosis in HNSCC.

Key words: Tertiary lymphoid structure, Head and neck squamous cell carcinoma, Clinicopathological characteristics, Immunotherapy, Tumor microenvironment, Prognosis

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