CD8^+T淋巴细胞表面抑制性受体NKG2A高表达在肺腺癌组织中的临床研究  

Clinical study of high expression of CD8^+T lymphocytes surface inhibitory receptor NKG2A in lung adenocarcinoma tissue

作　　者：马名扬 原翔 刘怡文[1] 孙江涛[2] MA Mingyang;YUAN Xiang;LIU Yiwen;SUN Jiangtao(Clinical Medical College of He′nan University of Science and Technology the First Affiliated Hospital of He′nan University of Science and Technology Cancer Institute of He′nan University of Science and Technology He′nan Key Laboratory of Cancer Epigenetics,He′nan Province,Luoyang 471003,China;Clinical Medical College of He′nan University of Science and Technology the First Affiliated Hospital of He′nan University of Science and Technology,He′nan Province,Luoyang 471003,China)

机构地区：[1]河南科技大学临床医学院,河南科技大学第一附属医院,河南科技大学肿瘤研究所,河南省肿瘤表观遗传重点实验室,河南洛阳471003 [2]河南科技大学临床医学院,河南科技大学第一附属医院,河南洛阳471003

出　　处：《中国医药导报》2020年第18期15-18,27,F0003,共6页China Medical Herald

基　　金：国家自然科学基金资助项目(81702820);河南省卫生和计划生育委员会医学科技攻关计划联合共建项目(2018020273);河南省洛阳市科技计划医疗卫生项目(1813003A)。

摘　　要：目的分析CD8^+T淋巴细胞表面抑制性受体NKG2A表达与肺腺癌患者临床病理特征及5年生存期的相关性,并探讨其临床意义及预后价值。方法选择2014年1月~2015年3月河南科技大学第一附属医院手术切除的130例表皮生长因子受体(EGFR)为阳性的肺腺癌患者癌组织及相应癌旁肺组织石蜡包埋标本为研究对象,采用免疫组织化学方法检测其组织中浸润的CD8^+T淋巴细胞表面NKG2A蛋白表达情况,并分析NKG2A的表达与肺腺癌患者临床病理特征及5年生存期的相关性;采用Cox回归法分析各因素对预后的影响;采用Kaplan-Meier法分析NKG2A蛋白高表达与生存时间之间相关性。结果肺腺癌及相应癌旁肺组织中浸润的CD8^+T淋巴细胞胞膜均可见NKG2A蛋白表达,在肺腺癌组织中,中、低分化NKG2A免疫组化评分高于高分化,且低分化高于中分化(P <0.05)。NKG2A蛋白高表达与肺腺癌患者的分化程度、淋巴结转移、临床分期及5年生存情况具有相关性(P <0.05)。NKG2A蛋白高表达为影响肺腺癌患者预后的独立危险因素。且NKG2A蛋白高表达患者的5年生存率及中位生存时间均明显低于低表达,差异有统计学意义(P <0.05)。结论 CD8^+T淋巴细胞表面抑制性受体NKG2A高表达,可能通过削弱其抗肿瘤免疫,促进了肺腺癌的发生发展。抑制NKG2A表达可能为肺腺癌的免疫治疗提供新的思路和有效治疗手段。Objective To analyze the correlation between expression of CD8+T cell surface inhibitory receptor NKG2A and clinicopathological characteristics and 5-year survival in patients with lung adenocarcinoma,and to explore its clinical significance and prognostic value.Methods From January 2014 to March 2015,130 cases of lung adenocarcinoma with epidermal growth factor receptor(EGFR)(+)were resected in the First Affiliated Hospital of He′nan University of Science and Technology,and the paraffin-embedded samples of the carcinema tissues and adjacent lung tissues of patients with lung adenocarcinoma were selected as the research objects,immunohistochemistry was used to detect the expression of NKG2A protein on the surface of infiltrated CD8^+T lymphocytes,and the correlation between NKG2A expression and clinicopathological characteristics and 5-year survival in patients with lung adenocarcinoma was analyzed.The influence of each factor on prognosis was analyzed by Cox regression method.The correlation between NKG2A protein expression and survival time was analyzed by Kaplan-Meier method.Results The expression of NKG2A protein was observed in the membrane of infiltrated CD8^+T lymphocytes in lung adenocarcinoma and corresponding adjacent lung tissues,in lung adenocarcinoma tissues,the immunohistochemical score of NKG2A was higher than that of high differentiation and low differentiation than that of medium differentiation(P<0.05).High expression of NKG2A protein was associated with differentiation,lymph node metastasis,clinical stage and 5-year survival in patients with lung adenocarcinoma(P<0.05).The degree of differentiation,lymph node metastasis,clinical stage and high expression of NKG2A protein were independent risk factors for the prognosis of patients with lung adenocarcinoma.Moreover,the 5-year survival rate and median survival time of patients with high NKG2A protein expression were significantly lower than those with low expression,with statistically significant differences(P<0.05).Conclusion The high expressio

关 键 词：肺腺癌 CD8^+T淋巴细胞 自然杀伤细胞表面抑制性受体A 预后 

分 类 号：R734.2[医药卫生—肿瘤]