结直肠癌肝转移与肿瘤局部免疫微环境的关系  

Comparison of local immune microenvironment between liver-metastasis colorectal cancer and non-liver-metastasis colorectal cancer

作　　者：邹一丰[1] 蔡泽荣[1] 陈钰锋[1] 戎煜明[2] 吴现瑞[1] 袁瑞学[3] 何晓生[1] 吴小剑[1] 兰平[1] 

机构地区：[1]中山大学附属第六医院结直肠外科,广州510655 [2]中山大学肿瘤防治中心外科 [3]中山大学胃肠病学研究所

出　　处：《中华胃肠外科杂志》2013年第6期547-551,共5页Chinese Journal of Gastrointestinal Surgery

基　　金：国家自然科学基金（81072046）;教育部博士点专项基金（20100171110075）;广东省医学科学技术研究基金（STJJ20101107445221197902271012）;中山大学医科青年教师科研启动基金（3171913）

摘　　要：目的探讨Ⅲ、Ⅳ期结直肠癌有肝转移与无肝转移患者肠道原发肿瘤局部免疫微环境的差异。方法收集2000年1月至2005年12月中山大学附属第一医院收治的167例行首次肠道肿瘤切除的Ⅲ-Ⅳ期结直肠癌患者标本，根据患者是否出现肝转移分为肝转移组和无肝转移组。通过免疫组织化学染色分析肿瘤组织中T淋巴细胞（CD3、CD4、CD8、CD45RO、IL-17和FOXP3）、B淋巴细胞（CD20）、NK细胞（CD57）、肿瘤相关巨噬细胞（CD68）、抗原提呈细胞（S100）、中性粒细胞（CD15）、肥大细胞（tryptase）、协同刺激分子（CD80和CD86）、T淋巴细胞效应分子（GZMB、FAS和FASL）以及MHC-Ⅱ类分子（HLADR）共计18个免疫分子的表达情况．并定量分析两组患者局部免疫指标表达的差异。结果肝转移组（17例）与无肝转移组（150例）患者的临床和病理资料比较，差异无统计学意义（均P〉0．05）。在分析的18个免疫指标中，与T淋巴细胞相关的CD8、CD45RO、IL-17、FAS及肥大细胞相关的tryptase在肝转移组中表达明显减少（P〈0．05）；其余免疫指标两组比较，差异均无统计学意义（均P〉0．05）。结论肠道原发肿瘤局部微环境中的T淋巴细胞及肥大细胞免疫减弱可能为Ⅲ、Ⅳ期结直肠癌肝转移提供了条件。Objective To investigate the difference of local immune microenvironment in primary tumors between liver-metastasis and non-liver-metastasis cohort in stage ]]I to IV colorectal cancer patients. Methods Tumor samples from 167 patients of colorectal cancer were harvested, who received tumor resection for the first time in The First Affiliated Hospital of Sun Yat-sen University from 2000 to 2005. Patients were divided into two groups according to liver metastasis or not. Expressions of 18 immune markers, including CD3, CD4 and CD8 were examined and quantified by immunohistochemistry staining. Results No significant differences of gender, age, BMI, tumor differentiation, pathology type and preoperative CEA level were found between the two groups. The expressions of CDS, CD45RO, IL-17, tryptase and FAS were lower in liver-metastasis group as compared to non-liver-metastasis group （all P〈0.05）. Conclusions Decrease of the number of T lymphocyte and mast cell may play an important role in local infiltration of immune microenvironment of stage III to IV eolorectal cancer with liver metastasis.

关 键 词：结直肠肿瘤 肝转移 免疫微环境 

分 类 号：R735[医药卫生—肿瘤]