非小细胞肺癌中M2型巨噬细胞对临床预后的影响  

Prognostic signiicance of M2 macrophages in non-small cell lung cancer

作　　者：李育刚[1] 韩扬[1] 史阳[1] 符雪莲[1] 王军臣[1] 

机构地区：[1]同济大学附属东方医院病理科,上海200120

出　　处：《肿瘤》2014年第4期349-356,共8页Tumor

摘　　要：目的:探讨非小细胞肺癌(non-small-cell lung cancer,NSCLC)组织中CD163+M2型巨噬细胞与患者生存期之间的关系,以及NSCLC细胞中血管内皮生长因子(vascular endothelial growth factor,VEGF)表达对M2型巨噬细胞募集的影响。方法:回顾性分析132例NSCLC患者的临床病理特征,采用免疫组织化学法检测其癌巢旁间质和癌巢内CD163+M2型巨噬细胞密度、微脉管密度以及肿瘤细胞VEGF表达量;并对患者生存情况进行随访。应用Pearson相关系数评估CD163+M2型巨噬细胞密度、微脉管密度与生存期之间的关系以及肿瘤细胞表达VEGF与癌巢旁CD163+M2型巨噬细胞浸润情况之间的关系。采用log-rank法和COX回归模型对患者预后进行单因素及多因素生存分析。结果:微血管、微淋巴管密度与癌巢旁CD163+M2型巨噬细胞浸润密度呈正相关(r=0.673,P=0.001;r=0.652,P=0.003),癌巢旁CD163+M2型巨噬细胞浸润密度与生存期呈负相关(r=-0.538,P=0.000);癌巢内CD163+M2型巨噬细胞密度与微血管、微淋巴管密度以及生存期均无关(r=-0.004,P=0.964;r=0.054,P=0.538;r=0.144,P=0.099)。癌巢旁CD163+M2型巨噬细胞密度与肿瘤细胞VEGF表达呈正相关(r=0.624,P=0.000),但癌巢内CD163+M2型巨噬细胞密度与VEGF表达无关(r=-0.004,P=0.960)。癌巢旁CD163+M2型巨噬细胞高密度组患者的预后较低密度组差(χ2=53.341,P<0.05)。临床分期(P=0.000)和癌巢旁CD163+M2型巨噬细胞密度(P=0.002)是NSCLC患者的独立危险因素。结论:癌巢旁CD163+M2型巨噬细胞可能通过促进微脉管的生成,影响NSCLC的进展和预后。NSCLC细胞中VEGF表达可能对癌巢旁CD163+M2型巨噬细胞起招募作用,后者有可能成为NSCLC临床治疗的靶点。Objective： To study the correlation between CD163^＋ M2 macrophages and survival of patients with non-small cell lung cancer （NSCLC）, and to explore the possible effect of vascular endothelial growth factor （VEGF） expression on M2 macrophage recruitment in NSCLC cells. Methods： The clinicopathological features of surgical specimens from 132 NSCLC patients were retrospectively reviewed. Immunohistochemistry was used to evaluate the density of CD163^＋ M2 macrophages, microvessel density/ microlymphatic vessel density （MVD/MLVD）, and VEGF expression in NSCLC cell nest and peritumoral stroma. The survival of the patients was followed-up. The correlations of CD163^＋ M2 macrophages and MVD/MLVD with survival as well as the VEGF expression with infiltrative level of peritumoral CD163^＋ M2 macrophages were evaluated by Pearson＇s correlation coefficient. Log-rank test and COX regression model were used for unvariate and multivariate analyses of prognostic factors. Results： There was a significant positive correlation between the density of peritumoral CD163^＋M2 macrophages and MVD/MLVD （r = 0.673, P = 0.001 ; r = 0.652, P = 0.003）, and a negative correlation between the density of peritumoral CD163^＋ M2 macrophages and the suvival （r = -0.538, P = 0.000）. However, there was no significant correlation found between the density of CD163^＋ M2 macrophages in cancer cell nest with MVD/MLVD and the survival （r = -0.004, P = 0.964; r = 0.054, P = 0.538; r = 0.144, P = 0.099）. The density of peritumoral CD163^＋ M2 macrophages had a significant correlation with VEGF expression in NSCLC cells （r = 0.624, P = 0.000）, but this correlation was not found between the density of CD163^＋ M2 macrophages and the VEGF expression in cancer cell nest （r = -0.004, P = 0.960）. The prognosis of NSCLC patients with a high density of peritumoral CD163^＋ M2 macrophages was poorer than those with a low density of peritumoral CD163^＋ M2 macrophages （Z2 = 53.341, P 〈 0.05）. TNM stage �

关 键 词：癌 非小细胞肺 巨噬细胞 血管内皮生长因子类 预后 微血管密度 微淋巴管密度 

分 类 号：R734.2[医药卫生—肿瘤]