不同分子分型乳腺癌原发灶内CD4^+、CD8^+ T淋巴细胞的表达差异研究  

Difference of CD4^+ and CD8^+ T lymphocytes expressions in primary lesions of different molecular classification breast cancer

作　　者：孙宇[1] 邹燕鹏[1] 邓素华[1] 黎冠宏[1] 钱朋飞[1] 张树平[1] 

机构地区：[1]惠州市第三人民医院乳腺中心,广东惠州516002

出　　处：《中国临床研究》2016年第2期153-156,161,共5页Chinese Journal of Clinical Research

基　　金：广东省惠州市科技计划项目(2014Y156)

摘　　要：目的探讨不同分子分型乳腺癌原发灶内T淋巴细胞(CD4^+、CD8^+)的表达差异及其意义。方法选取2014年1月至2015年12月于惠州地区经细针穿刺病理检查确诊为乳腺浸润性导管癌患者60例为研究对象,根据其分子分型分为四组:雌、孕激素受体阳性亚型的Luminal A型组(n=9)和Luminal B型组(n=25),人表皮生长因子受体2(HER2)过表达组(n=8)及三阴型组(雌、孕激素受体和HER2均阴性,n=18)。采用免疫组化法检测乳腺癌原发肿瘤内CD4^+、CD8^+T淋巴细胞浸润情况,比较不同浸润情况患者的肿瘤直径、临床分期、淋巴结转移情况等;分析不同分子分型乳腺癌原发灶内T淋巴细胞表达与其肿瘤直径、临床分期、淋巴结转移情况的相关性。结果Luminal A、B型组、HER2过表达组的CD4^+和CD8^+阳性率两两比较差异均无统计学意义(P均>0.05)而Luminal A、B型组、HER2过表达组的CD4^+阳性率及HER2过表达组CD8^+阳性率均高于三阴型组(P均<0.0083χ~2分割检验)。Luminal A、B型组肿瘤直径(P<0.05)、临床分期(P<0.05)和淋巴结转移率(P<0.0083)均分别低于HER2过表达组及三阴型组;四组CD4^+阳性和CD8^+阳性表达患者的肿瘤直径(P<0.05)、临床分期(P<0.05)和淋巴结转移率(P<0.0083)均分别低于CD4^+阴性和CD8^+阴性表达患者。Spearman秩相关分析结果显示,四组患者原发灶内CD4^+阳性率、CD8^+阳性率与其肿瘤直径、临床分期、淋巴结转移率均分别呈负相关(P均<0.05)。结论不同分子分型乳腺浸润性导管癌原发灶内T淋巴细胞表达具有差异且其表达情况与临床病理特征均相关,或可用于患者病情的评估,为疾病的治疗提供依据。Objective To explore the difference of CD4＋ and CD8＋ T lymphocytes expressions in primary lesions of different molecular classification breast cancer and its significance.Methods Sixty patients who were diagnosed as having breast invasive ductal carcinoma by fine needle aspiration biopsy between January 2014 and December 2015 in Huizhou area were selected as research objects.The patients were divided into four groups：estrogen/progesterone receptor（ER/PR）positive Luminal A group（n =9） and Luminal B group（n =25）,human epidermal growth receptor 2（HER2） over-expression group（n = 8） and triple negative group[ER（-）,PR（-）,HER2（-）,n = 18）].Immunohistochemistry was used to detect CD4~＋ and CD8~＋ T lymphocytes infiltration situation in primary lesions of breast cancer.The tumor diameter /clinical classification and lymph node metastasis situation of different lymphocytes infiltration situation were compared.The correlations of CD4~＋ and CD8~＋ T lymphocytes expressions in primary lesions of different molecular classification breast cancer with tumor diameter,clinical classification and lymph node metastasis situation were analyzed.Results There were no significant differences in CD4~＋ positive rate and CD8~＋ positive rate among Luminal A group,Luminal B group and HER2over-expression group by pairwise comparisons（all P 0.05）,while the CD4~＋ positive rate in Luminal A group,Luminal B group and HER2 over-expression group were all significantly higher than those in triple negative group[all P 0.0083（for χ~2 cutting test）],but the CD8~＋ positive rate only in HER2 over-expression group was higher than that in triple negative group（P 0.0083）.The tumor diameter,clinical classification and lymph node metastasis rate in Luminal A and B groups were significantly lower than those in HER2 over-expression group and triple negative group,respectively[P 0.05,P 0.0083].In all the four groups,the tumor diameter /clinical classification and lymph node metastasis rate in pati

关 键 词：乳腺浸润性导管癌 分子分型 人表皮生长因子受体2 原发灶 CD4^+ CD8^+ 表达 临床病理特征 

分 类 号：R737.9[医药卫生—肿瘤]