| Background:Colorectal cancer is a common malignant tumor in our country. Its morbidity is located in third of malignant tumors. With the westernization of lifestyle, the morbidity of colorectal cancer is increasing, seriously threating to human health. In recent years, tertiary lymphoid tissue was found in lung cancer, breast cancer and other malignant tumor. The existence of this structure is closely related to the better prognosis of patients with breast cancer, oral cancer. However, few studies were conducted on TLT in colorectal cancer. There is no research report on the presence of TLT and its clinical significance in colorectal cancer in our country now.Objectives:Investigate the existence of TLT in colorectal cancer. Analyze the relationship between TLT and the prognosis of patients, and explore the clinical value of TLT as a prognostic marker in colorectal cancer. At the same time, the relationship between TLT and other clinical pathological parameters is analyzed, providing a theoretical basis for the new immunotherapy strategy.Methods:1) Our study is a retrospective study, and a total of 110 colorectal cancer patients operated in General Surgery Department of PLA General Hospital was included. We used electronic medical record system to collect all clinical pathological data of the patients. Follow up was conducted.2) HE stained tissue samples of patients were taken from the Department of pathology in our hospital. According to the infiltration of lymphocytes in tumor tissues, patients were divided into lymphocyte infiltration group and lymphocyte deficiency group.5-year survival rates between the two groups were compared.3) From the Department of pathology the tumor specimens of patients in lymphocyte infiltration group were retrieved. Four white slices were sliced for each patient to make immumohistochemical staining. The T cells, B cells, FDC, and HEV were identified by using different markers of CD3, CD20, CD21 and PNAd in tumor tissues. The existence of TLT in the tumor was judged according to these kinds of immunohistochemical markers. The correlation between TLT and the prognosis of colorectal cancer patients was analyzed by Kaplan-Meier curve method and log-rank test.Results:1) A total of 91 cases were observed obvious lymphocyte infiltration in HE stained slices of tumor specimens from 110 patients (83%), and 19 cases were observed lymphocyte deficiency (17%). The 5-year survival rate of 110 patients was 62.7%. There was no significant difference in the clinical pathological characteristics of lymphocyte infiltration group and lymphocyte deficiency group in age, sex, tumor location, degree of differentiation, TNM stage (p>0.05). There were significant differences between the two groups in N stage (p<0.05). The prognosis of lymphocyte infiltration group was significantly better than the lymphocyte deficiency group (p<0.05).2) After immunohistochemical staining, the results were grouped according to four immunohistochemical markers, classic TLT group (15%), non-classic TLT group (40%), no TLT group (28%). There was no significant difference in the overall prognosis of the three groups (p>0.05). Stratified analysis of three groups of patient regards TNM stage and other clinical parameters were conducted. When with TNM stage III or poorly differentiated tumor, the prognosis of patients in classic TLT group was better than patients in the other two groups (p<0.05).Conclusions:Lymphocyte infiltration is present in most colorectal cancer, and its presence correlates with N stage. Patients with tumor infiltrating lymphocyte have a better prognosis than patients with lymphocyte deficiency in tumor. Immunohistochemistry confirmed the presence of TLT in part of the colorectal cancer. In patients with TNM III or poorly differentiated tumor, the presence of classic TLT suggests a better prognosis. |
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