调节性T细胞和CD8~＋T细胞在恶性黑色素瘤中的表达及其与预后的关系  

The expression of Tregs and CD8^+T cells in malignant melanoma and its relationship with prognosis

作　　者：苏月颖 安秀梅[1] 赵华[1] 魏枫[1] 张新伟[1] 

机构地区：[1]天津医科大学肿瘤医院免疫室、国家肿瘤临床医学研究中心、天津市肿瘤免疫与生物治疗重点实验室,300060

出　　处：《天津医药》2015年第9期1026-1030,共5页Tianjin Medical Journal

基　　金：973子课题基于纳米技术的肺癌早期检测研究资助项目(2012CB9333004);国家自然科学基金资助项目(81171983);天津市科委应用基础面上项目资助项目(12JCYBJC16100)

摘　　要：目的探讨调节性T细胞(Tregs)和CD8+T细胞在黏膜恶性黑色素瘤和肢端恶性黑色素瘤局部免疫微环境中表达情况的差异,及其与患者预后的关系。方法采用免疫组织化学染色法对58例恶性黑色素瘤组织进行染色,检测Foxp3+Tregs和CD8+T细胞的浸润情况,分析两者与临床病理指标及预后的相关性。结果 Foxp3与CD8+T细胞阳性表达无相关关系。黏膜恶性黑色素瘤组织中Foxp3+Tregs数量明显高于肢端恶性黑色素瘤(t=2.648,P=0.011);肿瘤直径≥3 cm、有淋巴结转移、有远处转移的恶黑患者Foxp3highTregs相对较高(P<0.05)。存在溃疡的恶性黑色素瘤患者中,CD8high组所占比例明显高于无溃疡者(33.3%vs 5.9%,P<0.05)。Foxp3high组的中位无进展生存期(PFS)是12个月,明显低于Foxp3low组(31个月);CD8high组的中位PFS是25个月,明显高于CD8low组(中位PFS 12个月);亚组分析显示Foxp3highCD8low组患者中位PFS是7个月,明显低于Foxp3highCD8high组(25个月)、Foxp3lowCD8low组(18个月)以及Foxp3lowCD8high组(59个月)。不同肿瘤位置、Foxp3+Treg数量、CD8+T细胞数量、有无远处转移的恶性黑色素瘤患者中位PFS不同。结论 Tregs的数量与恶性黑色素瘤的进展密切相关,黏膜恶性黑色素瘤预后欠佳可能与Tregs浸润有关。Objective To investigate the different distribution of regulatory T cells （Tregs） and CD8＋T cells in the local immune microenvironment of mucosal malignant melanoma and cutaneous malignant melanoma, and analyze the relationship between the two indicators and the prognosis of patients. Methods Immunohistochemistry staining was used to assess the expression of Foxp3＋Tregs and CD8＋T cells in tumor microenvironment of 58 patients with malignant melanoma. The correlation between two factors, clinicopathological characteristics, and prognosis were analyzed. Results There is no correlation between the expression of Foxp3 and CD8. The number of Foxp3＋Tregs was significantly higher in mucosa malignant melanoma than that in cutaneous malignant melanoma （t=2.648, P=0.011）. The proportion of Foxp3highTregs was significantly higher in patients with tumor diameter≥3 cm, lymph node metastasis and distant metastasis than that in patients with tumor diameter〈3 cm, no lymph node metastasis and no distant metastasis （P〈0.05）. In addition, in patients with ulceration that proportion was significantly higher in CD8high group than that in patients without ulceration （33.3%vs 5.9%, P〈0.05）. The median progression-free surial （PFS） was 12 months in Foxp3high group, which was significantly longer than that of Foxp3low group （31 months, P〈0.05）. The median PFS was significantly higher in CD8high group （25 months） than that of CD8low group （12 months, P〈0.05）. Subgroup analysis showed that the median PFS was 7 months in Foxp3high CD8low group, which was significantly lower than that of Foxp3highCD8high group （25 months） and Foxp3lowCD8low group （18 months, P=0.003）. Univariate analysis showed that median PFS was different in patients with different tumor location, different number of Foxp3＋Treg, different number of CD8＋T cells, and distant metastases. Conclusion The number of Tregs is closely associated with metastasis in patients with malignant melanoma. Compared with cutaneo

关 键 词：黑色素瘤 T淋巴细胞 CD8阳性T淋巴细胞 肿瘤逃逸 预后 

分 类 号：R739.5[医药卫生—肿瘤]