乳腺癌淋巴结微小转移状态下前哨与非前哨淋巴结免疫细胞的改变  

Immunological cells in sentinel and non-sentinel lymph nodes of breast cancer patients with small tumor deposits in lymph nodes

作　　者：黎剑[1] 詹文华[1] 蔡世荣[1] Bembenek A Schlag PM 

机构地区：[1]中山大学附属第一医院外科,广州510080

出　　处：《中华实验外科杂志》2007年第1期7-8,F0003,共3页Chinese Journal of Experimental Surgery

摘　　要：目的观察乳腺癌淋巴结微小转移状态下前哨淋巴结（SLN）与非前哨淋巴结（Non-SLN）免疫细胞密度的改变。方法53例符合研究标准的女性乳腺癌患者按SLN不同转移状态分为阴性、游离肿瘤细胞及微转移3组。从各组随机选择6对SLN和Non—SLN与DC-LAMP，CD68，CD123，Foxp3抗体行免疫组织化学染色，半定量评估染色细胞密度改变；所有SLN和Non-SLN蜡块切片均行与DC-LAMP抗体免疫反应的免疫组织学检查以确认成熟树突状细胞（DC）。蔡司图像分析系统定量分析每个淋巴结DC-LAMP阳性细胞的相对密度（DC—LAMP阳性细胞面积／淋巴结面积）。Wicoxon检验和Mann-Whimey检验分别用于DC-LAMP阳性细胞的相对密度的组内和组间比较。结果DC—LAMP阳性细胞密度改变显著。组内比较显示阴性组和微转移组SLN内DC-LAMP阳性细胞平均密度较Non-SLN高（P〈0．05）；组间比较显示微转移组SLN和Non-SLN内DC-LAMP阳性细胞密度较阴性组显著升高（P〈0．05）。结论SLN和Non-SLN内DC-LAMP＋细胞平均密度在淋巴结肿瘤转移形成早期发生改变，揭示SLN在肿瘤与引流淋巴结免疫相互作用中起重要作用。Objective The aim is to investigate the density of Immunological cells in SLN and Non-SLN of breast cancer patients with small tumor deposits in lymph node. Methods 3 groups of female breast cancer patients with different SEN metastatic status （ Negative, Isolated tumor cells, Micrometastasis） were established. 6 pairs of SLN and Non-SLN were selected from each group and immuno-stained with DC-LAMP, CD68, CD123, Foxp-3 antibody, the density of immunological cells were semi-quantitatively evaluated by counting under high-power microscope. One section of all SLN and Non-SLN of these patients underwent immunohistochemical examination using the DC-LAMP-antibody for identification of mature dendritic cells. The density of the DC-LAMP ＋ -cells of each slide was quantified by a Zeiss imaging system enregistering the percentage of the area occupied by DC-LAMP ＋ -cells. The Wicoxon-test and Mann-Whitney-test were used to compare the mean density of DC-LAMP ＋ -cells of SLN and Non-SLN individually in each group and interindividually between the different groups respectively. Results The change of DC-LAMP ＋ cells is dominant among the immunological cells in lymph node. The DC-LAMP ＋ - cell density increased significantly in the SLN compared to Non-SLN for patients with tumor free lymph nodes and patients with micrometastases in the SLN （ P 〈 0.05 ） ; but a significantly increased DC-density in SLN and Non-SLN of patients with micrometastases compared Negative group （ P 〈 0.05 ）. Conclusion The resalts further underlined the prominent role of the SLN for tumor-lymph node interactions revealing significant differences between SLN and Non-SLN in regard to the density of DC-LAMP ＋ -cells in the early process of formation of lymph node metastasis.

关 键 词：乳腺癌 前哨淋巴结 游离肿瘤细胞 微转移 树突状细胞 

分 类 号：R686[医药卫生—骨科学]