胃淋巴上皮瘤样癌中免疫相关调节因子分析  

Analysis of immune regulatory factors in lymphoepithelioma-like gastric carcinoma

作　　者：唐敏[1] 李琳[1] 王晖[1] 王征[2] 武晓楠[1] 李超[1] 

机构地区：[1]北京医院肿瘤内科国家老年医学中心,北京100730 [2]北京医院病理科国家老年医学中心,北京100730

出　　处：《中国临床医生杂志》2017年第6期25-29,共5页Chinese Journal For Clinicians

基　　金：北京医院院级课题项目(BJ-2015-125)

摘　　要：目的分析胃淋巴上皮瘤样癌(LELGC)肿瘤微环境中肿瘤浸润淋巴细胞表型及程序性死亡分子-1(PD-1)/程序性死亡分子配体-1(PD-L1)的特点。方法分析4例LELGC患者的临床特征,对肿瘤石蜡组织免疫组织化学法检测CD3、CD4、CD8、CD20、Foxp3、PD-1、PD-L1,原位杂交法检测EB病毒编码RNA(EBER)。结果 4例肿瘤组织EBER均阳性,肿瘤浸润淋巴细胞以CD8阳性细胞为主。所有病例中PD-L1均高表达,其中2例以肿瘤浸润淋巴细胞表达为主,另2例以肿瘤细胞表达为主。结论 LELGC肿瘤微环境具有肿瘤浸润淋巴细胞丰富、PD-L1高表达等特点。PD-1/PD-L1抑制剂或许是治疗LELGC的一个有效手段。Objective To investigate the features of the tumor infiltrating lymphocyte immunophenotype, programmed death ligand-1 and programmed death ligand-1 in lymphoepithelioma-like gastric carcinoma （LELGC）. To discuss the theoretical foundations of using PD-1/PD-L1 inhibitors in LELGC. Method The clinical and histological data of four patients with LELGC were retrospectively analyzed. The expression of CD3, CD4, CDS, CD20, Foxp3, PD-1, PD- L1 in tumor microenvironment was detected by immunohistochemical methods. The Epstein-Barr virus-encoded small RNA（EBER） was detected by in situ hybridization. Result EBER was positive in all four tumors. The immunohisto- chemical examination indicated that the CD3 positive lymphocytes were much more than the CD20 positive lympho- cytes, especially the CD8 positive lymphocytes. Foxp3 positive lymphocytes are rare. The PD-L1 was over-expressed （ about 50% - 70% ） in all four tumors. The PD-L1 was expressed by tumor infiltrating lymphocytes in two tumors and by tumor cells in the other two tumors. The expression of PD-1 was about 10% - 20%. Conclusion There are a- bundant tumor infiltrating lymphocytes and over-expression of PD-L1 in the tumor microenvironment of LELGC. The inhibitors of PD-1/PD-L1 may be an effective treatment for the LELGC patients.

关 键 词：胃肿瘤 淋巴上皮瘤样癌 肿瘤浸润淋巴细胞 程序性死亡分子-1 程序性死亡分子配体-1 

分 类 号：R730.3[医药卫生—肿瘤]