大肠癌局部微环境中细胞免疫功能状况与预后的关系  

The relationship between the status of cellular immune function in local microenvironment and prognosis in patients with colorectal cancer

作　　者：冯国光[1] 陈峰[1] 丁新德[1] 朱松明[1] 高铭[1] 顾志相[1] 

机构地区：[1]上海交通大学医学院附属新华医院崇明分院,上海202150

出　　处：《现代中西医结合杂志》2015年第21期2299-2302,共4页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的 探讨大肠癌根治术后患者细胞免疫功能状况与预后的关系。方法 取146例大肠癌患者手术切除标本石蜡块。采用免疫组织化学染色技术检测肿瘤、瘤旁1 cm和瘤旁8-10 cm肠壁组织（正常肠壁组织）中CD3＋、CD4＋、CD8＋、B细胞、自然杀伤细胞（NK细胞）、树突状细胞（DC细胞）和转录因子叉头框蛋白P3＋调节性T细胞（Foxp3＋Tregs）水平,采用Kaplan-Meier和Cox回归分析评估这些指标对预后的影响。结果 肿瘤组织中CD3＋、CD4＋、CD8＋、NK细胞、DC细胞和Foxp3＋Tregs表达量显著高于瘤旁1 cm组织及正常肠壁组织（P均〈0.05）;肿瘤组织中CD8＋、NK细胞和DC细胞高表达组T3、T4期和区域淋巴结转移例数均显著低于低表达组（P均〈0.05）;肿瘤组织中Foxp3＋Tregs高表达组高TNM分期、术后肿瘤复发转移和死亡例数均显著高于低表达组（P均〈0.05）;肿瘤组织内Foxp3＋Tregs高表达与TNM高分期和差的预后有显著关系（P均〈0.05）,并且是术后的一个独立预后因素。结论 肿瘤组织中Foxp3＋Tregs表达量与大肠癌根治术后患者预后密切相关,肿瘤组织中Foxp3＋Tregs高表达是大肠癌根治术患者预后的一个独立危险因素。Objective It is to approach the relationship between the status of cellular immune function in local microenvi- ronment and prognosis in patients with colorectal cancer. Methods Paraffin blocks of operation resection of eoloreetal cancer were obtained from 146 patients. The levels of CD3^＋, CD4^＋, CD8^＋, B ceils, natural kill cells （ NK）, dendritic cells （DC） and the transcription factor forkhead box protein P3 ＋ regulatory T cells （ Foxp3 ＋ Tregs） in the tissues of tumor and the intes- tine wall adjacent to tumor tissues of 1 cm and 8 to 10 cm were detected by immunohistoehemistry staining technique to evaluate the relationship on prognostic effects by Kaplan-Meier and Cox regression analysis. Results The intratumoral CD3^＋, CD4^＋, CD8^＋, NK ceils, DC cells and Foxp3 ＋ Tregs counts were significantly higher than those in peritumoral 1 cm tissue and normal intestinal tissue （ all P 〈 0.05 ） ; The cases of T3 , T4 stage and regional lymph node metastasis in the intratumoral CD8^＋ , NK and DC cells high counts group were significantly lower than those in the intratumoral CD8^＋, NK and DC ceils low counts group （ all P 〈 0.05 ） ; the cases of T3 , T4 stage, recurrence and metastasis of tumor and deaths after operation in the in- tratumoral Foxp3 ＋ Tregs high counts group were significantly higher than those in the intratumoral Foxp3 ＋ Tregs low counts group （all P 〈 0. 05 ） ; the increased intratumoral Foxp3 ＋ Tregs counts were associated with higher TNM stage and worse prognosis and was an independent prognostic factor for overall survival （ all P 〈 0.05 ）. Conclusion The intratumoral Foxp3 ＋ Tregs counts are closely associated with the prognosis in patients with eolorectal cancer after radical resection. The higher in- tratumoral Foxp3 ＋ Tregs counts is an independent prognostic risk factor in patients with colorectal cancer after radical resection.

关 键 词：大肠癌 细胞免疫 Foxp3+Tregs 预后 

分 类 号：R735.34[医药卫生—肿瘤]