结直肠癌组织CD3免疫组织化学评分与肿瘤分化程度及预后关系分析  

Analysis of relationship between CD3 immunohistochemical scores and tumor differentiation degrees and prognosis in colorectal cancer

作　　者：张畅 胡阿锦 龚苗子[1] 王跃[1] 王淑芳[1] 张雨 王云帆[1] 缪琦[1] 张晋夏[1] ZHANG Chang;HU A-jin;GONG Miao-zi;WANG Yue;WANG Shu-fang;ZHANG Yu;WANG Yun-fan;MIAO Qi;ZHANG Jin-xia

机构地区：[1]北京大学首钢医院病理科

出　　处：《中国医药生物技术》2019年第4期347-351,共5页Chinese Medicinal Biotechnology

基　　金：北京大学首钢医院临床重点项目(1-138-2)

摘　　要：目的分析结直肠癌组织CD3免疫组织化学评分与患者性别、年龄、肿瘤分化程度、TNM分期、组织抗原表达及血清肿瘤抗原关系,评估CD3免疫组织化学评分在结直肠癌免疫状态评估中的作用。方法采用免疫组织化学方法对116例结直肠癌患者肿瘤标本进行CD3免疫组织化学染色并评分,将患者分成CD3低表达组与CD3高表达组。比较分析两组患者的性别和年龄组成、肿瘤分化程度及pTNM分期。同时比较两组肿瘤组织样本CEA、EGFR、MUC1、HER2、mesothelin、PD-1、PD-L1及FOXP3免疫组织化学评分,并且比较两组患者血清中CEA、CA125及CA199水平。结果174例组织标本CD3免疫组织化学染色均可见阳性细胞,评分均在1~12分之间。CD3低表达组年龄<30岁患者比例(9.20%)高于CD3高表达组(0%),>65岁患者比例(33.33%)低于高表达组(57.47%)。CD3低表达组高分化癌(3.45%)及中分化癌(60.92%)比例低于CD3高表达组(分别为9.20%和74.71%),而低分化癌(27.59%)及复发/转移癌(8.05%)比例高于CD3高表达组(分别为9.20%和6.90%)。pTNM分期越高预后越差,CD3免疫组织化学评分越低(P<0.05)。CD3低表达组患者组织样本中PD-1(P<0.001)、PD-L1(P<0.001)及FOXP3(P<0.01)水平低于CD3高表达组,而两组患者血清肿瘤标志物(CEA、CA125和CA199)水平无明显差异。结论CD3免疫组织化学评分可广泛应用于结直肠癌肿瘤组织,并反映患者的肿瘤相关免疫状态与预后。Objective The role of CD3 immunohistochemistry in the immune status assessment of colorectal cancer was evaluated by analyzing the relationship between CD3 immunohistochemistry scores and patients' gender,age,tumor differentiation degree,TNM stage,tissue antigen expression and serum tumor antigen levels.Methods CD3 immunohistochemical staining was performed on tumor specimens of 116 patients with colorectal cancer.The patients were then divided into groups with low CD3 expression and high CD3 expression according to CD3 immunohistochemistry scores.The gender and age composition,TNM stage and tumor differentiation degree of the two groups were compared and analyzed.Meanwhile,the immunohistochemical scores of CEA,EGFR,MUC1,HER2,mesothelin,PD-1,PD-L1 and FOXP3 in tumor tissue samples of the two groups were compared,and the serum levels of CEA,CA125 and CA199 were compared between the two groups.Results All the 116 tissue specimens showed positive cells by immunohistochemical staining of CD3,and the scores were all between 1 and 12 points.The proportion of patients younger than 30 years old (9.20%) in the CD3 low-expression group was higher than that in the CD3 high-expression group (0%).However,the proportion of patients over 65 years old (33.33%) in the CD3 low-expression group was lower than that in the high-expression group (57.47%).The proportion of hyperdifferentiated cancer (3.45%) and medium-differentiated cancer (60.92%) in the CD3 low-expression group was lower than that in the CD3 high-expression group (9.20% and 74.71%,respectively),but the proportion of low-differentiated cancer (27.59%) and recurrent/metastatic cancer (8.05%) was higher than that in the CD3 high-expression group (9.20% and 6.90%,respectively).Patients with higher TNM stage had worse prognosis and lower CD3 immunohistochemical scores.The levels of PD-1 (P< 0.001),PD-L1 (P < 0.001) and FOXP3 (P < 0.01) in tissue samples of patients with low CD3 expression were lower than those of patients with high CD3 expression.There was no significant

关 键 词：抗原 CD3 预后 抗原 肿瘤 结直肠肿瘤 肿瘤免疫 

分 类 号：R735.34[医药卫生—肿瘤]