| 才巨星,李光召,祝宝让,李静,杨武威.瘤内三级淋巴结构用于预测软组织肉瘤经冷冻消融联合免疫治疗后预后[J].中国介入影像与治疗学,2025,22(5):315-318 |
| 瘤内三级淋巴结构用于预测软组织肉瘤经冷冻消融联合免疫治疗后预后 |
| Intratumoral tertiary lymphoid structure for predicting prognosis of soft tissue sarcoma after cryoablation combined with immunotherapy |
| 投稿时间：2025-02-20 修订日期：2025-04-22 |
| DOI：10.13929/j.issn.1672-8475.2025.05.003 |
| 中文关键词: 肉瘤 三级淋巴结构 免疫治疗 冷冻术 无进展生存期 |
| 英文关键词:sarcoma tertiary lymphoid structures immunotherapy cryosurgery progression free survival |
| 基金项目:国家卫生健康委能力建设和继续教育中心课题（GWJJ2022100306）。 |
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| 中文摘要: |
| 目的 观察瘤内三级淋巴结构（TLS）用于预测软组织肉瘤（STS）经冷冻消融联合免疫治疗后预后的价值。方法 回顾性纳入43例接受冷冻消融的STS患者，其中38例联合、5例未联合免疫治疗，6例存在、37例无瘤内TLS；对比观察其间无进展生存期（PFS）的差异，利用Cox回归及受试者工作特征曲线分析瘤内TLS用于预测STS经冷冻消融联合免疫治疗后PFS的价值。结果 接受联合与未联合免疫治疗的冷冻消融的STS患者之间PFS差异无统计学意义（P＜0.05）。38例接受联合治疗患者中，6例存在、32例无瘤内TLS，前者中位PFS长于后者（6个月 vs. 3个月，P＜0.05）。单因素及多因素Cox回归分析结果显示，瘤内TLS及白细胞介素-2受体（IL-R2）水平均为STS经冷冻消融联合免疫治疗后PFS的独立影响因素（P均＜0.05）；以瘤内TLS预测患者3、6及9个月PFS的曲线下面积（AUC）分别为0.550、0.577及0.699，IL-R2分别为0.658、0.742及0.583，二者联合分别为0.762、0.787及0.881，均高于二者单独预测（P均＜0.05）。结论 瘤内TLS有助于预测STS经冷冻消融联合免疫治疗后预后；联合IL-R2可进一步提高其预测效能。 |
| 英文摘要: |
| Objective To observe the value of intratumoral tertiary lymphoid structure （TLS） for predicting prognosis of soft tissue sarcomas （STS） after cryoablation combined with immunotherapy. Methods Forty-three STS patients who underwent cryoablation were retrospectively enrolled， including 38 cases underwent cryoablation combined with but 5 cases without immunotherapy， among them 6 cases with but 37 cases without intratumoral TLS. The progression free survival （PFS） were compared between those with and without immunotherapy， as well as those with and without intratumoral TLS. The value of intratumoral TLS for predicting prognosis of STS after cryoablation combined with immunotherapy was analyzed with Cox regression and receiver operating characteristic curves. Results No significant difference of PFS was found between STS patients undwerwent cryoablation combined with and without immunotherapy （P＜0.05）. Among 38 cases underwent cryoablation combined with immunotherapy， 6 cases were found with but 32 cases without intratumoral TLS， and the median PFS of the former was longer than that of the latter （6 months vs. 3 months， P＜0.05）. Univariate and multivariate Cox regression analysis revealed that intratumoral TLS and interleukin 2 receptor （IL-R2） were both independent influencing factors of PFS of STS patients after cryoablation combined with immunotherapy （both P＜0.05）. The area under the curve （AUC） of intratumoral TLS for predicting PFS of STS patients at 3， 6 and 9 months was 0.550， 0.577 and 0.699， of IL-R2 was 0.658， 0.742 and 0.583， respectively， while of combination of the above two was 0.762， 0.787 and 0.881， respectively， all higher than of each intratumoral TLS and IL-R2 alone （all P＜0.05）. Conclusion Intratumoral TLS could be used to predict prognosis of STS after cryoablation combined with immunotherapy. Combining with IL-R2 might further improve its predictive efficacy. |
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