喉鳞状细胞癌中的间质肿瘤浸润淋巴细胞（sTIL）：与咽皮瘘、复发和死亡率的相关性
Stromal tumor-infiltrating lymphocytes (sTIL) in laryngeal squamous cell carcinoma: association with pharyngocutaneous fistula, recurrence, and mortality.
文献信息
| PMID | 42900202 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Selçuk Erol |
| 作者单位 | Department of Otorhinolaryngology, University of Health Sciences, Ankara Atatürk Sanatoryum Training and Research Hospital, Ankara, Türkiye. drselcukerol95@gmail.com. |
| 期刊 | European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery |
| SCI 分区 | Q1 |
| IF | 2.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 咽喉科 |
中文摘要
目的： 既往研究提示肿瘤浸润淋巴细胞在喉鳞状细胞癌中具有有利的预后作用，尽管结果因免疫细胞表型、评估方法、肿瘤分区和队列特征而异。本研究评估了sTIL百分比与术后咽皮瘘、复发和死亡率之间的相关性。
方法： 这项单中心回顾性队列纳入2019年1月至2024年3月期间接受原发或挽救性全喉切除术的81例患者。sTIL依据国际TILs工作组指南在H&E切片上进行评估。由于sTIL呈非正态分布（Shapiro-Wilk W = 0.908；p < 0.001），采用非参数检验。相关性采用Mann-Whitney U检验、Kruskal-Wallis检验、卡方/Fisher精确检验和Spearman相关进行分析。生存采用Kaplan-Meier和Cox回归分析。
结果： sTIL中位数为30%（IQR：10-50%）。sTIL与瘘、复发、死亡率、手术方式、淋巴血管或神经周围侵犯、T分期或分化分级均无显著相关性（所有p > 0.05）。死亡率与年龄较大相关（68岁 vs. 60岁；p = 0.004）。死亡患者观察随访时间更长，反映的是时间-事件结构而非预后相关性。Kaplan-Meier分析显示不同sTIL组间无生存差异（log-rank p = 0.914）。在简化多变量Cox模型中，年龄（HR：1.05；p = 0.043）和淋巴血管侵犯（HR：4.79；p < 0.001）与死亡率独立相关，而sTIL则不然（HR：1.01；p = 0.600）。
结论： 基于H&E的sTIL评分与咽皮瘘、复发或总生存无显著相关性。鉴于瘘事件数量有限，瘘相关发现应视为探索性和产生假设性的。年龄和淋巴血管侵犯与死亡率独立相关。这些非确证性发现需要在采用空间和表型免疫谱分析的更大规模研究中加以验证。
英文摘要
PURPOSE: Previous studies suggest a favorable prognostic role for tumor-infiltrating lymphocytes in laryngeal squamous cell carcinoma, although findings vary by immune-cell phenotype, assessment method, tumor compartment, and cohort characteristics. This study evaluated associations between sTIL percentage and pharyngocutaneous fistula, recurrence, and mortality after surgery.
METHODS: This single-center retrospective cohort included 81 patients who underwent primary or salvage total laryngectomy between January 2019 and March 2024. sTIL was assessed on H&E sections according to International TILs Working Group guidelines. Because sTIL was non-normally distributed (Shapiro-Wilk W = 0.908; p < 0.001), non-parametric tests were used. Associations were assessed using Mann-Whitney U, Kruskal-Wallis, chi-square/Fisher's exact tests, and Spearman correlation. Survival was analyzed using Kaplan-Meier and Cox regression.
RESULTS: Median sTIL was 30% (IQR: 10-50%). sTIL was not significantly associated with fistula, recurrence, mortality, surgical approach, lymphovascular or perineural invasion, T stage, or differentiation grade (all p > 0.05). Mortality was associated with older age (68 vs. 60 years; p = 0.004). Deceased patients had longer observed follow-up, reflecting time-to-event structure rather than a prognostic association. Kaplan-Meier analysis showed no survival difference by sTIL group (log-rank p = 0.914). In the reduced multivariable Cox model, age (HR: 1.05; p = 0.043) and lymphovascular invasion (HR: 4.79; p < 0.001) were independently associated with mortality, whereas sTIL was not (HR: 1.01; p = 0.600).
CONCLUSIONS: H&E-based sTIL scoring was not significantly associated with pharyngocutaneous fistula, recurrence, or overall survival. Given the limited number of fistula events, the fistula-related findings should be considered exploratory and hypothesis-generating. Age and lymphovascular invasion were independently associated with mortality. These non-confirmatory findings require validation in larger studies using spatial and phenotypic immune profiling.