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摘要: 目的 探讨125I粒子植入放疗对前列腺癌免疫微环境的影响。方法 利用免疫组织化学技术检测、比较cT1~3N0M0期前列腺癌行125I粒子植入治疗前、后前列腺癌细胞PD-L1表达情况，以及肿瘤微环境中CD3+T、CD4+T、CD8+T、PD-1+T细胞的表达情况变化。结果 前列腺肿瘤细胞PD-L1阳性表达率为55.6%(35/63);肿瘤组织中均可见CD3+、CD4+、CD8+T细胞浸润; 55.6%的组织中可见PD-1+T细胞表达，但数量较少; 经125I粒子植入治疗后行经尿道前列腺切除术的前列腺癌组织中，肿瘤细胞PD-L1表达率明显上调95.8%(22/23)，而且表达强度也增加。结论 前列腺癌肿瘤微环境中均可见浸润性T淋巴细胞，但肿瘤抗原特异性T细胞很少; 125I粒子植入放疗可以促进前列腺癌患者的肿瘤免疫反应，但具有一定时间窗; 联合免疫检查点阻断治疗是合理的，或许也很有必要。Abstract: Objective To evaluate the effects of iodine-125 permanent brachytherapy on prostate cancer immune microenvironment.Methods Immunohistological analyses and comparison of the expression of PD-L1 and tumor infiltrating lymphocytes (TILs, CD3+, CD4+, CD8+, PD-1+) on tissue sections between archival prostate biopsy samples and corresponding TURP or RP were performed for≤cT3 prostate cancer patients before receiving brachytherapy.Results PD-L1 were expressed in 55.6% (35/63) cases, and tumor-infiltrating T lymphocytes were seen in all cases. PD-1+T cells were seen in 55.6% cases, but with very small density. After brachytherapy, CD3+, CD4+, CD8+T cells were increased significantly. PD-1+T cells had a moderate raise, and the expression of PD-L1 on PCa cell significantly raised.Conclusion All PCa had TILs expression in cancer immune microenvironment, but may be not tumor antigen-specific T-cell. Iodine-125 permanent brachytherapy can stimulate anti-tumor immunity in a particular time window, and when combined with immunotherapy (Immune Checkpoint Inhibitors), it's reasonable, even necessary.
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