肿瘤浸润T淋巴细胞在乳腺癌原发灶中的表达与预后的关系  

Tumor-infiltrating T lymphocytes relationship with prognosis in primary tumors in breast cancer

作　　者：蒋正华 韩旭[2] 

机构地区：[1]浙江金华广福医院十二病区腹部肿瘤外科,浙江金华321000 [2]湖州师范学院附属第一医院胸外科,浙江湖州313000

出　　处：《中国现代医生》2015年第6期13-16,23,共5页China Modern Doctor

基　　金：国家医学教育发展中心课题项目(2012-03-07-143)

摘　　要：目的研究肿瘤浸润T淋巴细胞在乳腺癌原发灶中的表达及其与预后的关系。方法回顾性收集乳腺癌患者105例临床资料、病理资料和石蜡包埋病理标本,采用免疫组化检测CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞在乳腺癌原发灶的表达,采用COX单因素和多因素分析无病生存率(DFS)和总生存率(OS)相关因素。结果 105例患者乳腺癌原发灶CD3+阳性101例(96.19%),CD4+阳性55例(52.38%),CD8+阳性71例(67.62%),CD3+T淋巴细胞浸润与年龄、肿瘤直径、临床分期、SBR分级、ER表达、PR表达、HER-2表达、淋巴结状态无关,CD4+T淋巴细胞浸润与SBR分级、HER-2表达有关(P<0.05),CD8+T淋巴细胞浸润与SBR分级有关(P<0.05)。单因素分析显示,临床分期、SBR分级、HER-2阳性、淋巴结转移、CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润与DFS有关(P<0.05);临床分期、SBR分级、HER-2阳性、淋巴结转移、CD4+浸润、CD8+浸润与OS有关(P<0.05);多因素分析显示,CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润是DFS的保护因素(HR=0.655、0.534,P<0.05);CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润是OS的保护因素(HR=0.525、0.628,P<0.05)。结论乳腺癌原发灶普遍存在CD3+T淋巴细胞浸润,CD4+T淋巴细胞、CD8+T淋巴细胞浸润与病变程度有关,两者均与乳腺癌较好预后有关。Objective To research tumor-infiltrating T lymphocytes in breast primary tumor expression and the relationship with prognosis. Methods Retrospectively collected clinical data of 105 cases of breast cancer patients, pathological data and paraffin-embedded pathological specimens, using immunohistochemical detection of CD3＋T cells, CD4^＋T cells, CD8^＋T cells in primary tumors in breast cancer, used univariate and multivariate COX factor analysis of diseasefree survival（DFS）, overall survival（OS） related factors. Results The primary tumor CD3＋positive 101 cases（96.19%）,in 105 cases with breast cancer CD4^＋positive 55 cases（52.38%）, CD8^＋positive 71 cases（67.62%）, CD3＋T cells infiltration with age, tumor size, clinical stage, differentiation degree, SBR grade, ER expression, PR expression, HER-2expression and lymph node status were independent, CD4^＋T cells infiltration were related to SBR grade, HER-2（P〈0.05）, CD8^＋T cells infiltration were related to cell differentiation and SBR grade（P〈0.05）. Univariate analysis showed that clinical stage, degree of differentiation, SBR grade, HER-2 positive, lymph node metastasis, CD4^＋T cells infiltration, CD8^＋T cells infiltration were related to DFS（P〈0.05）; clinical stage, SBR grade, HER-2-positive, lymph node transfer, CD4^＋T cells infiltration, CD8^＋infiltration were related to OS（P〈0.05）; multivariate analysis shows, CD4^＋T cells infiltration, CD8^＋T cells infiltration were protective factor for DFS（HR=0.655, 0.534, P〈0.05）; CD4^＋T cells infiltration,CD8^＋T cells infiltration were protective factor for OS（HR=0.525,0.628, P〈0.05）. Conclusion The prevalence of breast cancer primary tumor infil tration of CD3＋T cells, CD4^＋T cells, CD8^＋T cells infiltration and related lesions, both with better prognosis in breast cancer.

关 键 词：乳腺癌 肿瘤浸润T淋巴细胞 CD4+T淋巴细胞 CD8+T细胞 生存率 

分 类 号：R737.9[医药卫生—肿瘤]