胃癌微环境中免疫活性细胞与患者预后的关系

Relationship between Immunocytes in the Tumor Microenvironment and Prognosis of Gastric Carcinoma

  • 摘要: 目的:主要研究胃癌局部浸润的记忆性T 细胞、树突状细胞和细胞毒性T 淋巴细胞与患者预后的关系。方法:选取60例胃癌组织蜡块,用免疫组化方法检测胃癌局部浸润的记忆性T 细胞、树突状细胞和细胞毒性T 淋巴细胞的数量及分布,分析局部免疫活性细胞与胃癌患者临床病理特征及预后的关系。结果:胃癌局部免疫活性细胞高表达者,淋巴结转移率较低。单因素分析显示,淋巴结转移、肿瘤直径、TNM分期、肿瘤组织局部浸润的记忆性T 细胞、细胞毒性T 淋巴细胞和树突状细胞及免疫细胞联合表达是胃癌患者预后的影响因素。多因素分析显示,淋巴结转移和记忆性T 细胞是胃癌患者预后的独立影响因素。结论:胃癌局部浸润的免疫活性细胞可以很好地预示淋巴结的转移情况。胃癌局部浸润的记忆性T 细胞对判断患者的预后有一定意义。

     

    Abstract: Objective: To investigate the relationship between the distribution and quantity of memory T lymphocytes, dendritic cells (DCs) and cytotoxic T lymphocytes in the tumor microenvironment and the prognosis of gastric carcinoma. Methods:Immunohistochemistry was used to assess the densities of CD45RO+, CD11c+ and CD 8 + cells in the tumor mi-croenvironment of60gastric cancer cases. These densities were evaluated for associations with clinicopathologic charac -teristics and survival. Results: The density of memory T lymphocytes, dendritic cells (DCs) and cytotoxic T lymphocytes in the tumor microenvironment was negatively correlated with regional lymph node metastasis. Kaplan-Meier survival analysis revealed that patients in the high-density groups for CD45RO+T, CD 11c+ (DCs), CD8 + T and CD45RO+TCD11c+ (DCs) CD8 + T had a significantly longer survival time than those in the corresponding low-density groups. Furthermore lymphatic metastasis, TNM stage and diameter of the primary tumor were correlated with the prognosis. In multivariate survival analy-sis, the density of CD 45RO+ T cells and lymph node metastasis remained independent prognostic factors with hazard ra-tios (95% CI) of 0.437 (0.192 -0.992 ) and 2.330 (1.136 -4.779 ), respectively. Conclusion: Immunocyte density is predictive of lymph node metastasis. The density of CD 45RO+T cells can be used as an independent prognostic factor.

     

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