CD4、CD8、FoxP3在子宫颈癌新辅助化疗前后表达的变化及临床价值  

Expression and Clinical Value of CD4,CD8 and FoxP3 in Neoadjuvant Chemotherapy for Cervical Cancer

作　　者：殷霞[1,2] 余敏华 张义[1] 狄文[1,2] 楼微华[1] YIN Xia;YU Minhua;ZHANG Yi(Department of Obstetrics and Gynecology,Renji Hospital,Shanghai Jiaotong University School of Medicine,Shanghai Key Laboratory of Gynecologic Oncology,Shanghai 200127,China;State Key Laboratory of Oncogenes and Related Genes,Shanghai Cancer Institute,Shanghai 200127,China)

机构地区：[1]上海交通大学医学院附属仁济医院妇产科上海市妇科肿瘤重点实验室,上海200127 [2]癌基因及相关基因国家重点实验室,上海200127

出　　处：《实用妇产科杂志》2019年第10期750-755,共6页Journal of Practical Obstetrics and Gynecology

基　　金：上海市重中之重临床医学中心和重点学科建设计划(编号:2017ZZ02016)

摘　　要：目的:探讨CD4、CD8、FoxP3在子宫颈癌新辅助化疗(NACT)前后表达的变化及临床价值。方法:选择上海交通大学医学院附属仁济医院妇产科2013年10月至2017年9月收治的应用NACT的局部晚期(ⅠB2~ⅡB)子宫颈癌患者NACT前后免疫组化检测CD4+、CD8+及FoxP3表达的变化,并通过计算机软件进行定量分析其与化疗疗效、无病生存期(PFS)、总体生存期(OS)之间的关系。结果:局部晚期子宫颈癌NACT前后CD4、CD8、FoxP3在组织中表达的变化与患者年龄、病灶大小无相关性(P>0. 05),但是CD4、CD8与子宫颈癌FIGO分期呈正相关(P <0. 05),与组织病理学分级呈负相关(P <0. 05)。NACT后CD4、CD8、FoxP3的平均单位面积阳性值较化疗前显著升高(P=0. 016,P=0. 009,P=0. 005);局部晚期子宫颈癌患者NACT疗效与CD4、CD8和FoxP3表达的变化无明显相关性(P>0. 05),但NACT后CD8表达的增加与患者PFS呈正相关(r=0. 309,P=0. 041),而与CD4(P=0. 581)、FoxP3(P=0. 134)无明显关系。患者的OS与CD4、CD8和FoxP3化疗前后表达的变化无明显相关性(P> 0. 05)。结论:局部晚期子宫颈癌NACT后,CD4、CD8、FoxP3表达较NACT前升高,CD4、CD8表达的变化与肿瘤分期、病理分级相关,而且CD8化疗前后的变化可以作为独立的预后指标。Objective:To explore the expression of CD4,CD8 and FoxP3 before and after neoadjuvant chemotherapy( NACT) in cervical cancer and the clinical value. Methods:67 Patients with locally advanced cervical cancer(ⅠB2-ⅡB) in the department of obstetrics and gynecology of Renji Hospital affiliated to Shanghai Jiaotong University school of medicine from October 2013 to September 2017 were included,and the expressions of CD4,CD8 and FoxP3 in patients’ samples before and after neoadjuvant chemotherapy were detected by immunohistochemical( IHC) staining. The relationship between the expression of CD4,CD8 and FoxP3 and the efficacy of chemotherapy,disease-free survival( DFS) and overall survival( OS) were quantitatively analyzed by computer software. Results:The expression of CD4,CD8 and FoxP3 in locally advanced cervical cancer before and after NACT was not correlated with the patient’s age and lesion size( P > 0. 05),but CD4 and CD8 were positively correlated with the FIGO stage of cervical cancer( P < 0. 05) and negatively correlated with the histological grade( P <0. 05). The average positive values of CD4,CD8 and FoxP3 per unit area after NACT were significantly increased than those before chemotherapy( P = 0. 016,P = 0. 009,P = 0. 005). There was no significant correlation between the efficacy of NACT and the expression of CD4,CD8 and FoxP3 in local advanced cervical cancer( P >0. 05). The increased expression of CD8( P = 0. 005) after NACT was positively related to DFS,but no relationship with CD4( P = 0. 581) or FoxP3( P = 0. 134). However,there was no significant difference between OS and expression of CD4,CD8 and FoxP3 before and after NACT( P > 0. 05). Conclusions:The expression of CD4,CD8 and FoxP3 was increased after NACT in locally advanced cervical cancer;the expression of CD4,CD8 is related to tumor stage and pathological grade,and CD8 can be used as an independent prognostic index.

关 键 词：新辅助化疗 子宫颈癌 免疫治疗 CD4 CD8 FOXP3 

分 类 号：R737.33[医药卫生—肿瘤]