Immunoscore in esophageal cancer evaluate the tumor microenvironment and predict prognosis.

2021 Fiscal Year Final Research Report

• Project/Area Number: 19K18146
• Research Category: Grant-in-Aid for Early-Career Scientists
• Allocation Type: Multi-year Fund
• Review Section: Basic Section 55020:Digestive surgery-related
• Research Institution: Osaka University
• Principal Investigator: Noma Toshiki 大阪大学, 医学系研究科, 招へい教員 (20804462)
• Project Period (FY): 2019-04-01 – 2022-03-31
• Keywords: 免疫 / 腫瘍浸潤リンパ球 / 食道癌 / 癌免疫微小環境 / Immunoscore / 化学療法 / 内視鏡生検 / 外科手術

Outline of Final Research Achievements

Immunoscore (IS), a new evaluation method for esophageal cancer that count and analyze tumor infiltrating lymphocytes (TIL) in the center and margin of tumor in resected specimens, which has not yet been reported in esophageal cancer, predicts postoperative prognosis. In addition, we found that evaluation of TIL using endoscopic biopsies of esophageal cancer before chemotherapy predicted the efficacy of chemotherapy. In this study, immunohistochemical staining of CD3- and CD8-positive lymphocytes as TIL in 300 surgical specimens was performed and converted to IS using software. The results showed that the higher the IS, the better the prognosis, especially in advanced cases.
146 case of endoscopic biopsies of esophageal cancer before chemotherapy showed that the higher the TIL density, the better the postoperative pathological response.

Free Research Field

消化器外科学

Academic Significance and Societal Importance of the Research Achievements

今回の研究で、食道癌の術前無治療外科切除標本においては、immunoscoreが高いほど良好な予後と相関し、術前化学療法前の内視鏡生検検体では、治療前のTIL密度が高いほど化学療法が奏功した。本研究での知見により、現在、食道がんのみならず種々のがんで、国際的に使用されている、TMN分類に代わる、新たな免疫予後予測の評価法として可能性を見出した。また、化学療法前の生検検体を用いて、治療効果を予測することで、患者さん個々のオーダーメイド治療の確立に大きく貢献し、最終的には食道がん全体の治療成績の改善につながるものと期待される。