肿瘤相关巨噬细胞在甲状腺乳头状癌中的分布及临床意义的初探

侯飞; 吕娟; 杨志贤; 李浩宇; 邓智勇

doi:10.3969/j.issn.1000-8179.2021.12.050

肿瘤相关巨噬细胞在甲状腺乳头状癌中的分布及临床意义的初探

The distribution and clinical significance of tumor-associated macrophages in papillary thyroid carcinoma

摘要

摘要:
目的初步探讨肿瘤相关巨噬细胞（tumor-associated macrophages, TAMs）及M2型TAMs与甲状腺乳头状癌（papillary thyroid carcinoma，PTC）临床病理特征的关系。
方法选取2010年1月至2017年12月云南省肿瘤医院昆明医科大学第三附属医院就诊的68例患者的临床资料，其中甲状腺癌51例（PTC 42例，甲状腺鳞状细胞癌9例），甲状腺良性病变17例。免疫组织化学法检测术后病理组织中TAMs和M2型TAMs的分布情况，并分析其与患者临床病理特征的关系。
结果甲状腺癌组织中CD68⁺TAMs、CD206⁺TAMs和CD68⁺/CD206⁺TAMs的分布强度均高于甲状腺良性病变（P<0.05）。在PTC组织内存在CD68⁻/CD206⁺TAMs形式的分布。42例PTC中，有淋巴结转移组及肿瘤大小≥2 cm组中CD68⁺TAMs和CD68⁺/CD206⁺TAMs的分布强度高于无淋巴结转移组和肿瘤大小<2 cm组（P<0.05）。在PTC大小<2 cm及Ⅰ期或Ⅱ期的情况下，CD206⁺TAMs分布强度高于CD68⁺TAMs（均P<0.001）。PTC组织中CD206⁺TAMs分布强度与CD68⁺TAMs分布强度呈正相关（P<0.05）。在PTC患者的T3、TgAb、FT3及FT4正常组与异常组之间CD68⁺TAMs的分布差异具有统计学意义（P<0.05）；CD68⁺/CD206⁺TAMs的分布分别在PTC患者的T3、FT3及FT4正常组与异常组之间差异具有统计学意义（P<0.05）。
结论 TAMs、M2型TAMs对PTC的发生具有一定促进作用，TAMs促进PTC颈部淋巴结转移、肿瘤的生长及影响甲状腺激素水平的调节；在PTC微环境中未发现M2型TAMs从属于TAMs的关系，而在PTC早期微环境中主要是以M2型TAMs为主。

Abstract:
Objective To preliminarily explore the relationship between tumor-associated macrophages (TAMs), M2 type TAMs and clinicopathological characteristics of papillary thyroid carcinoma (PTC).
Methods The study was based on data from patients enrolled in Yunnan Cancer Hospital from January 2010 to December 2017. Immunohistochemistry was used to detect the distribution of TAMs and M2 TAMs in the pathological tissues of 68 patients (51 cases of thyroid cancer, 42 cases of PTC, 9 cases of thyroid squamous cell carcinoma, and 17 cases of thyroid benign lesions) postoperatively. The distributions of TAMs and M2 TAMs in the tissues were detected by immumohistochemical staining, and the relationship between the results and clinicopathological characteristics were analyzed.
Results The distribution intensity of CD68⁺-, CD206⁺-, and CD68⁺/CD206⁺-labeled TAMs was higher in patients with thyroid cancer than in those with benign thyroid lesions (P<0.05). There were CD68^-/CD206⁺-labeled TAMs in PTC tissues. Among 42 patients with PTC, the distribution intensity of CD68⁺- and CD68⁺/CD206⁺-labeled TAMs was higher in the group with lymph node metastasis and tumor size ≥2 cm than in the group without lymph node metastasis and tumor size <2 cm (P<0.05). In patients with PTC size <2 cm and stage Ⅰ or Ⅱ tumor, the distribution intensity of CD206⁺-labeled TAMs was higher than that of CD68⁺-labeled TAMs (P<0.05). The distribution intensity of CD206⁺-labeled TAMs in PTC tissues was positively correlated with the distribution intensity of CD68⁺-labeled TAMs (P<0.05). There was a statistically significant difference in the distribution of CD68⁺-labeled TAMs between the T3, TgAb, FT3, and FT4 normal and abnormal groups among patients with PTC (P<0.05). The distribution of CD68⁺/CD206⁺-labeled TAMs was statistically significant in the T3, FT3, and FT4 normal and abnormal groups of patients with PTC (P<0.05).
Conclusions 1) TAMs and M2 TAMs have a certain role in promoting the occurrence of thyroid cancer. TAMs can promote PTC neck lymph node metastasis, tumor growth and affect the regulation of thyroid hormone levels. 2) In the thyroid cancer microenvironment, M2 TAMs were not found to be subordinate to TAMs. 3) M2 TAMs mainly existed in the early microenvironment of PTC.

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