本研究的目的是评估改良诊断活检适应免疫评分 (mISb) 在确定新辅助治疗局部晚期直肠癌 (LARC) 患者预后方面的预后意义。我们纳入了来自单个亚中心的 181 名 LARC 患者一项前瞻性研究比较基于短程放疗和长期放化疗 (CRT) 的总新辅助治疗 (TNT)。对基线时的肿瘤活检进行 CD8 和 CD3 T 细胞密度染色。 mISb 是使用 CD8 T 细胞密度的平均百分位数和 CD8/CD3 比率开发的。两组患者均分为低（0%-25%）、中（>25%-70%）和高（>70%-100%）。说明了不同淋巴细胞之间的相关性及其与生存的相关性。使用生存分析和Cox回归模型比较mISb和ISb对生存结果的预后价值，并分别评估mISb在TNT和CRT亚组中的作用。 在这项研究中，151名（83.4％）患者接受了手术，30名（83.4％）患者接受了手术。 16.6%）遵循观察和等待策略。 CD8 和 CD3 T 细胞密度之间存在很强的相关性（R=0.86，P<0.001），而 CD8 和 CD8/CD3 比率之间存在弱相关性（R=0.45）。整个队列的3年无病生存（DFS）为69.9%，其中低、中、高mISb组分别为57.2%、68.6%和85.5%（P=0.01），而ISb未能区分生存结果。多变量分析显示，mISb 是手术治疗患者 DFS 的独立预后因素（P=0.01）。具体而言，mISb 评分高的患者在 TNT 队列中表现出比其他亚组更长的 PFS（P=0.049），但在 CRT 人群中没有发现显着差异。 在这项研究中，mISb 在接受术前治疗的 LARC 患者中表现出显着的预后价值，尤其是在 TNT 子组中。这些发现可能有助于为患者调整新辅助治疗的强度。版权所有 © 2024。由 Elsevier Inc. 出版。

The purpose of this study was to assess the prognostic significance of the modified diagnostic biopsy-adapted immunoscore (mISb) in determining the outcomes for patients with locally advanced rectal cancer (LARC) in a neoadjuvant setting.We included 181 LARC patients from a single subcenter of a prospective study comparing total neoadjuvant therapy (TNT) based on short-course radiotherapy with long-term chemoradiotherapy (CRT). Tumor biopsies at baseline were stained for CD8+ and CD3+ T-cell densities. The mISb was developed using mean percentile of CD8+ T-cell density and CD8/CD3 ratios. Patients were classified into low (0%-25%), intermediate (>25%-70%), and high (>70%-100%) in both groups. The relativity among different lymphocytes and their correlation with survival were illustrated. Survival analyses and Cox regression models were used to compare the prognostic value of mISb and ISb for survival outcomes, and to assess the role of mISb in TNT and CRT subgroups respectively.In this study, 151 (83.4%) patients received surgery and 30 (16.6%) followed a watch and wait strategy. A strong correlation was found between CD8+ and CD3+ T-cell densities (R=0.86, P<0.001), while a weak correlation witnessed between CD8+ and CD8/CD3 ratio (R=0.45). The 3-year disease-free survival (DFS) for the entire cohort was 69.9%, with 57.2%, 68.6%, and 85.5% for the low, intermediate, and high mISb groups respectively (P=0.01), while ISb failed to distinguish survival outcomes. Multivariate analysis revealed mISb to be an independent prognostic factor for DFS in surgically treated patients (P=0.01). Specifically, patients with high mISb score showed longer PFS than other subgroups in the TNT cohort (P=0.049), but no significant difference was found in the CRT population.In this study, mISb demonstrates significant prognostic value in LARC patients receiving preoperative therapies, especially in the TNT subgroup. These findings may help tailor the intensity of neoadjuvant therapy for patients.Copyright © 2024. Published by Elsevier Inc.