肿瘤相关巨噬细胞在晚期胰腺癌组织中的浸润及其与预后的关系  

Prognostic significance of tumor-associated macrophage infiltration in advanced pancreatic cancer

作　　者：林显敢[1] 黄开红[2] 陈茵婷[2] 李海刚[3] 陈其奎[2] 

机构地区：[1]中山大学附属第二医院肿瘤科,广州510120 [2]中山大学附属第二医院消化内科,广州510120 [3]中山大学附属第二医院病理科,广州510120

出　　处：《中华实验外科杂志》2009年第10期1349-1351,共3页Chinese Journal of Experimental Surgery

摘　　要：目的探讨肿瘤相关巨噬细胞（TAM）在胰腺癌组织中的浸润及对胰腺癌患者生存和预后的影响。方法应用免疫组织化学方法检测胰腺癌及胰腺良性病变组织中TAM的特异性标志物CD68，了解TAM在胰腺癌组织和胰腺良性病变中的浸润密度，比较TAM高密度组与低密度组胰腺癌患者的生存差异，并对影响预后的多个临床病理因素进行单因素及多因素分析。结果在200倍高倍光学显微镜下计数，86例胰腺癌组织标本中TAM平均密度为29．6／HP，25例胰腺良性病变组织标本中TAM平均密度为14．2／HP。在胰腺癌组织中TAM浸润密度较良性病变组织中明显为高（P〈0．01）。胰腺癌患者中TAM低密度组的中位生存时间为（16．7±3．4）个月，1年累积生存率为73．8％；TAM高密度组的中位生存时间为（9．4±2．6）个月，1年累积生存率为20．1％。TAM低密度浸润胰腺癌患者1年生存率较TAM高密度患者为高（P〈0．01）。在胰腺癌患者中，低分化癌TAM浸润较明显。多因素分析显示，组织学分级及TAM浸润的密度是影响晚期胰腺癌生存的独立的预后因子。结论晚期胰腺癌组织中有明显的TAM浸润，TAM高密度浸润状态提示预后不良。Objective To investigate the influence of tumor-associated macrophage （TAM） infiltration on the survival and prognosis of patients with pancreatic cancer. Methods The expression of CD68, a TAM specific marker, in 86 patients with pancreatic cancer and 25 patients with benign pancreatic lesions was detected by SP immunohistochemistry to investigate the density of TAM. The correlation of TAM density to the prognosis of pancreatic cancer was analyzed. Cox multivariate proportional hazard model was used to analyze prognostic factors of pancreatic cancer. Results Under a microscope （ x 200）, the mean density of TAM was significantly higher in pancreatic cancer than in benign pancreatic lesions （29.6 vs. 14.2 per vision field, P 〈 0.01 ）. The one-year survival rate was significantly higher in low-density TAM group than in high-density TAM group of pancreatic cancer patients （73. 8% vs. 20. 1%, P 〈 0.01 ）. Univariate analysis showed that TAM infiltration was more obvious in poorly differentiated carcinoma than in the counterparts. Multivariate analysis revealed that histological grade and TAM infiltration status were independent predictors for pancreatic survival. Conclusion TAM infiltration is obvious in advanced pancreatic cancer,which indicates poor prognosis.

关 键 词：胰腺肿瘤 巨噬细胞 预后 免疫组织化学 

分 类 号：R735.9[医药卫生—肿瘤]