| Objective:To evaluate the prognostic values of lymph nodes metastasis-associated indexes in N2b stage colorectal cancer patients.Material and methods:Data of consecutive patients with colorectal cancer on N2b stage who were treated in our hospital between January 2008 and December 2009, were retrospectively analyzed, and the prognostic value of several indexes, including numbers of positive lymph node, numbers of negative lymph node, lymph node ratio LNR, log odds of positive lymph nodes LODDS, were analyzed in colorectal cancer patients on N2b stage.Results:Expect for number of negative lymph node (HR=0.65,95%CI:0.37-1.15), numbers of positive lymph node, LNR, LODDS were independent prognostic factors for colorectal cancer patients on N2b stage, the HR values were 1.89 (95%CI:1.07-3.38),2.24 (95%CI:1.27-3.98), 2.13 (95CI%:1.20-3.77) respectively. The areas under the ROC curves were 0.666,0.654,0.594 and 0.607 for LNR, LODDS, numbers of positive lymph node and numbers of negative lymph node respectively, but no statistical significance was observed between LNR (P=0.125) or LODSS (P=0.192) and number of postitve lymoh node. Subgroup analysis showed that, the HR value of LNR on colon cancer was 9.00(95%CI:1.58-51.32), which was higher than 2.07(95%CI:0.92-5.22) on rectal cancer, indicating that LNR was more valuable in evaluating the prognosis of colon cancer than rectal cancer. This tendency was also abserved in other indexes.Conclusion:Numbers of positive lymph nodes, LNR, LODDS were all independent prognostic factos for colorectal cancer on N2b stage, and all indexes showed superior prognostic value in colon cancer than rectal cancer.Objective:To investigate the density or ratio of CD4+T cells, CD8+T cells, PD-1+T cells and Foxp3+Treg cells and the expression of PD-L1 among the tissues of tumor and lymph node of rectal cancer on T3NOMO stage, and to explore the relationship between the immunestatus and survival of rectal cancer patients.Material and methods:Patients with pT3NOMO rectal cancer who received the first treatment in our hospital between January 2007 and December 2009 were followed up till the end of Feb 2016. We selected 20 cases with disease recurrence and 20 cases without disease recurrence, respectively. The paraffin-embedded specimens of the central area of tumor, the area of tumor invasion front, the boundary between tumor and intestinal mucosa, the normal intestinal mucosal, and the largest lymph node of each patient were used for the detection the following indicators by immunohistochemical staining and image scan:1. the density of CD4+T cells, CD8+T cells, Foxp3+Treg cells, PD1+T cells,2. the positive expression rate of PD-L1,3. the ratio of these types of positive cells. TissueGnostics panoramic tissue cell analyzer machine system was used for analyses.Results:1. CD4+T cells, CD8+T cells, PD-1+T cells, PD-L1+cells and Foxp3+Treg cells can be detected in all kinds of tissues. And the denstity of CD4+T cells, CD8+T cells, PD-1+T cells, Foxp3+Treg cells and the positive expression rate of PD-L1 in the tissues of tumor invasion front and boundary between tumor and intestinal mucosa were significantly higher than that in normal intestinal mucosa (P<0.05). In addition, the ratio of all these types of cells were higher in the region of lymph node cortex than that in the total lymph node(P<0.05), expcept PD-L1+cells.2. We found that the density or ratio of CD4+T cells, CD8+T cells, PD-1+T cells and Foxp3+Treg cells were significantly different between patients with disease recurrence and patients without disease recurrence(P<0.05). It was also shown that the density or ratio of CD4+T cells, CD8+T cells and PD1+T cells correlated with prognosis positively. However, the density or ratio of Foxp3+Treg cells correlated with prognosis negatively. The density of CD8+T cells and PD-1+T cells among the area of tumor invasion front in patients without disease recurrence were significantly higher than that in patients with disease recurrence (P<0.05). But there were no significant difference of the density of CD4+T cells (P=0.126) and Foxp3+Treg cells (P=0.084) between these two groups of patients. In normal intestinal mucosa tissues, no any difference of density or ratio was observed for all kinds of cells. There was no significant difference of the positive expression rate of PD-L1 between theses two groups.Conclusion:The density or ratio of CD4+T cells, CD8+T cells and PD-1+T cells in tumor tissues correlated positively with the prognosis of rectal cancer patients, while Foxp3+Treg cells correlated negatively with the prognosis. The correlation between all these kinds of immune cells and prognosis in tissues of lymph nodes was similar to that in tissues of tumor. Suggesting that the immunestatues in regional lymph nodes can also be used to evaluate patients’prognosis as primary tumor in rectal cancer. |
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