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食管鳞癌肿瘤微环境免疫细胞浸润特征对顺铂 / 5-FU 同步放化疗方案疗效及预后预测价值研究

Study on the Predictive Value of Immune Cell Infiltration Characteristics in the Tumor Microenvironment of Esophageal Squamous Cell Carcinoma for the Efficacy and Prognosis of Cisplatin/5-FU Concurrent Chemoradiotherapy Regimen

投稿时间：2025-11-11 修订日期：2026-01-26

DOI：

中文关键词: 食管鳞癌肿瘤微环境免疫细胞浸润顺铂 5 - 氟尿嘧啶同步放化疗疗效预后

英文关键词:Esophageal squamous cell carcinoma Tumor microenvironment Immune cell infiltration Cisplatin 5-fluorouracil Concurrent chemoradiotherapy Efficacy Prognosis

基金项目:陕西省自然科学基础研究计划项目(2023-JC-QN-0970)；西安交通大学第一附属医院院基金(2024-RK-12)

作者	单位	邮编
曹旭欢	西安交通大学第一附属医院	710061
雒小佳	西安交通大学第一附属医院
孙玄子	西安交通大学第一附属医院
惠蓓娜^*	西安交通大学第一附属医院	710061

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中文摘要:

目的：探究食管鳞癌肿瘤微环境中免疫细胞浸润特征对顺铂 / 5-FU 同步放化疗方案疗效及预后的预测价值，为临床制定个体化治疗方案提供理论依据。? 方法：收集 2020 年 2 月至 2022 年 4 月本院接受顺铂 / 5-FU 同步放化疗的 160 例食管鳞癌患者，采用免疫组织化学染色法检测肿瘤组织中 CD3+T 细胞、CD8 + 细胞毒性 T 细胞、Tregs 细胞和 CD163 巨噬细胞的浸润密度。按照实体瘤疗效评价标准（RECIST 1.1 版）评估疗效，通过 ROC 曲线评估免疫细胞浸润特征对疗效及预后的预测价值，采用 Kaplan-Meier 法进行生存分析。? 结果：160 例患者中，CR 28 例、PR 40 例、SD 50 例、PD 42 例，有效率为 73.75%。无效组 CD8 + 细胞毒性 T 细胞浸润密度显著低于有效组，Tregs 细胞和 CD163 巨噬细胞浸润密度显著高于有效组（P<0.05）。ROC 曲线分析显示，CD8 + 细胞毒性 T 细胞、Tregs 及 CD163?M2 样巨噬细胞浸润密度均能显著区分疗效有效组与无效组（P<0.001），AUC 值分别为 0.846、0.898 和 0.877。生存分析显示，CD8 + 高浸润组存活率显著高于低浸润组，Tregs 和 CD163 低浸润组存活率显著高于高浸润组（P<0.05）；Tregs 及 CD163?M2 样巨噬细胞浸润密度对预后有显著预测价值（P<0.05），CD8 + 细胞毒性 T 细胞则无（P>0.05）。结论：食管鳞癌肿瘤微环境中 CD8 + 细胞毒性 T 细胞、Tregs 细胞和 CD163 巨噬细胞的浸润特征可作为顺铂 / 5-FU 同步放化疗方案疗效及预后的预测指标，为临床个体化治疗提供参考。?

英文摘要:

Objective: To explore the predictive value of immune cell infiltration characteristics in the tumor microenvironment of esophageal squamous cell carcinoma (ESCC) for the efficacy and prognosis of cisplatin/5-FU concurrent chemoradiotherapy regimen, and to provide a theoretical basis for formulating individualized clinical treatment plans.? Methods: A total of 160 ESCC patients who received cisplatin/5-FU concurrent chemoradiotherapy in our hospital from February 2020 to April 2022 were collected. The infiltration densities of CD3+T cells, CD8+ cytotoxic T cells, Tregs cells and CD163 macrophages in tumor tissues were detected by immunohistochemical staining. The efficacy was evaluated according to the Response Evaluation Criteria in Solid Tumors (RECIST version 1.1). The predictive value of immune cell infiltration characteristics for efficacy and prognosis was assessed by ROC curve, and survival analysis was performed using Kaplan-Meier method.? Results: Among the 160 patients, there were 28 cases of CR, 40 cases of PR, 50 cases of SD and 42 cases of PD, with an effective rate of 73.75%. The infiltration density of CD8+ cytotoxic T cells in the ineffective group was significantly lower than that in the effective group, while the infiltration densities of Tregs cells and CD163 macrophages in the ineffective group were significantly higher than those in the effective group (P<0.05). ROC curve analysis showed that the infiltration densities of CD8+ cytotoxic T cells, Tregs and CD163?M2-like macrophages could significantly distinguish the effective group from the ineffective group in terms of efficacy (P<0.001), with AUC values of 0.846, 0.898 and 0.877, respectively. Survival analysis showed that the survival rate of the high CD8+ infiltration group was significantly higher than that of the low infiltration group, and the survival rates of the low Tregs and low CD163 infiltration groups were significantly higher than those of the high infiltration groups (P<0.05). The infiltration densities of Tregs and CD163?M2-like macrophages had significant predictive value for prognosis (P<0.05), while CD8+ cytotoxic T cells did not (P>0.05).? Conclusion: The infiltration characteristics of CD8+ cytotoxic T cells, Tregs cells and CD163 macrophages in the tumor microenvironment of ESCC can be used as predictive indicators for the efficacy and prognosis of cisplatin/5-FU concurrent chemoradiotherapy regimen, providing a reference for clinical individualized treatment.?

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