目的:在图像引导自适应放射治疗时代,临床靶体积(CTV)的定义是各种实体瘤的挑战,包括食管癌(EC)。许多肿瘤微环境因素,例如,肿瘤细胞增殖或癌症干细胞,假设参与微观肿瘤扩展(MTE)。因此,这项研究评估了FAK的表达,ILK,CD44,HIF-1α,新辅助放化疗后肿瘤切除(NRCHTR)的EC患者中Ki67,并将这些标志物与MTE相关联。
方法:采用多重免疫荧光染色法对10例EC患者福尔马林固定石蜡包埋的肿瘤切除标本进行分析。由于在NRCHT+R之前,金基准标记已经通过内窥镜在近端和远端肿瘤边界植入,标记与MTE的相关性是可行的。
结果:在EC患者的肿瘤切除标本中,FAK+的总百分比,CD44+,HIF-1α+,肿瘤巢中的Ki67+细胞高于肿瘤基质中的Ki67+细胞,Ki67+细胞的结果达到统计学意义(p<0.001)。相反,ILK+细胞在肿瘤间质中表达较高,尽管没有统计学意义。在三个病人中,发现了超出基准标记的MTE,达到31毫米。
结论:我们的研究结果表明,FAK的整体表达,HIF-1α,肿瘤巢中Ki67和CD44较高,而ILK在肿瘤间质中较高。未发现原始CTV中有残留肿瘤细胞的患者与没有肿瘤细胞的患者之间的TME差异。因此,没有足够的证据表明TME会影响患者个体所需的CTV切缘.
■BO-EK-148042017和BO-EK-177042022on20.06.2022,DRKS00011886,https://drks。去/搜索/去/审判/DRKS00011886。
OBJECTIVE: In the era of image-guided adaptive radiotherapy, definition of the clinical target volume (CTV) is a challenge in various solid tumors, including esophageal cancer (EC). Many tumor microenvironmental factors, e.g., tumor cell proliferation or cancer stem cells, are hypothesized to be involved in microscopic tumor extension (MTE). Therefore, this study assessed the expression of FAK, ILK, CD44, HIF-1α, and Ki67 in EC patients after neoadjuvant radiochemotherapy followed by tumor resection (NRCHT+R) and correlated these markers with the MTE.
METHODS: Formalin-fixed paraffin-embedded tumor resection specimens of ten EC patients were analyzed using multiplex immunofluorescence staining. Since gold fiducial markers had been endoscopically implanted at the proximal and distal tumor borders prior to NRCHT+R, correlation of the markers with the MTE was feasible.
RESULTS: In tumor resection specimens of EC patients, the overall percentages of FAK+, CD44+, HIF-1α+, and Ki67+ cells were higher in tumor nests than in the tumor stroma, with the outcome for Ki67+ cells reaching statistical significance (p < 0.001). Conversely, expression of ILK+ cells was higher in tumor stroma, albeit not statistically significantly. In three patients, MTE beyond the fiducial markers was found, reaching up to 31 mm.
CONCLUSIONS: Our findings indicate that the overall expression of FAK, HIF-1α, Ki67, and CD44 was higher in tumor nests, whereas that of ILK was higher in tumor stroma. Differences in the TME between patients with residual tumor cells in the original CTV compared to those without were not found. Thus, there is insufficient evidence that the TME influences the required CTV margin on an individual patient basis.
UNASSIGNED: BO-EK-148042017 and BO-EK-177042022 on 20.06.2022, DRKS00011886, https://drks.de/search/de/trial/DRKS00011886 .