摘要
结直肠癌是世界范围内常见的恶性肿瘤之一,在中国其发病率和病死率逐年增加,年轻化趋势也愈加明显。在肿瘤治疗过程中,免疫及炎症介导的抗肿瘤反应尤为重要,并在肿瘤的发生、发展过程中发挥重要作用。近年来研究发现,中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)、血小板与淋巴细胞比值(platelet-lymphocyte ratio,PLR)、预后营养指数(prognostic nutritional index,PNI),这些系统炎症指标对行根治性结直肠癌手术患者的预后具有指导作用。此外,肿瘤浸润淋巴细胞(tumor-infiltrating lymphocytes,TIL)和肿瘤相关巨噬细胞(tumor-associated macrophages,TAM)也已成为研究热点。早在2005年就有研究发现,对于行根治性切除手术的结直肠癌患者来说,其肿瘤组织中浸润的淋巴细胞与这部分患者的预后相关,往往TIL密度越高其预后越好。近年来越来越多的研究在不断验证这些结论的同时也在深入探究其机制。传统的TNM分期系统虽已被广泛应用于结直肠癌患者的预后预测,但其代表的是肿瘤的生物学行为,不能精确地预测肿瘤患者的死亡及复发风险。有研究建立了个体化的预测模型,利用列线图将预测模型可视化,更高效能地对可切除性结直肠癌的预后进行预测。今后应探讨炎症与免疫指标在可切除性结直肠癌中的预测价值,同时建立更高效能的结直肠癌预后模型,以便对可切除性结直肠癌患者的预后进行更精准的预测。
Colorectal cancer is one of the most common malignant tumors in the world.The incidence and mortality of colorectal cancer are increasing year by year in China,and the trend of younger age is becoming more and more obvious.Immune and inflammation-mediated anti-tumor responses are particularly important in the process of tumor treatment,and play an important role in the multi-stage development of tumors.In recent years,researchers have found that neutrophil-lymphocyte ratio(NLR),plateletlymphocyte ratio(PLR)and prognostic nutritional index(PNI),which are systemic inflammatory markers,can guide the prognosis of patients undergoing radical colorectal cancer surgery.In addition,tumor-infiltrating lymphocytes(TIL)and tumor-associated macrophages(TAM)have also become a focus of research.As early as 2005,scholars found that for patients with colorectal cancer undergoing radical resection,the infiltrating lymphocytes in the tumor tissues were related to the prognosis of these patients,and the higher the density of infiltrating lymphocytes,the better the prognosis of the patients.In recent years,more and more studies have been conducted to verify these conclusions and explore the underlying mechanism.Traditional TNM staging system has been widely used to predict the prognosis of patients with colorectal cancer,however,it represents the biological behavior of the tumor and cannot accurately predict the risk of death and recurrence of patients with colorectal cancer.Some studies have established an individualized prediction model and visualized the prediction model by using the nomogram to predict the prognosis of resectable colorectal cancer patient with higher efficiency.This paper aimed to explore the predictive status of inflammatory markers and immune markers in resectable colorectal cancer,and at the same time,to search for a more efficient prognosis model of colorectal cancer to predict the prognosis of patient with resectable colorectal cancer more accurately.
作者
马祎菲
梁新军
魏少忠
MA Yifei;LIANG Xinjun;WEI Shaozhong(Department of Gastrointestinal Oncology Surgery,Hubei Cancer Hospital Affiliated of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430079,Hubei Province,China;Colorectal Cancer Clinical Research Center of Hubei Province,Wuhan 430079,Hubei Province,China;Colorectal Cancer Clinical Research Center of Wuhan,Wuhan 430079,Hubei Province,China;Department of Abdominal Oncology,Hubei Cancer Hospital Affiliated of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430079,Hubei Province,China)
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2021年第9期845-851,共7页
China Oncology
基金
国家重点研发计划资助(2017YFC0908204)
湖北省技术创新专项(重大项目)(2019ACA135)
湖北省卫健委联合基金重点项目(WJ2019H121)
湖北省卫健委重点项目(WJ2021Z001)。
关键词
结直肠癌
预后
炎症
肿瘤浸润淋巴细胞
免疫
列线图
Colorectal cancer
Prognosis
Inflammation
Tumor-infiltrating lymphocytes
Immune
Nomogram
