乳腺癌微环境中T细胞与临床病理因素的相关性  

Correlation between T cell and clinicopathological factors in breast carcinoma microenvironment

作　　者：周游 张启新 陈莉[3] ZHOU You;ZHANG Qixin;CHEN Li(Department of Pathology,Haimen District People's Hospital of Nantong City,Jiangsu Nantong 226100,China;Department of Thoracic Surgery,Haimen District People's Hospital of Nantong City,Jiangsu Nantong 226100,China;Department of Pathology,Medical School of Nantong University,Jiangsu Nantong 226100,China)

机构地区：[1]南通市海门区人民医院病理科,江苏南通226100 [2]南通市海门区人民医院胸外科,江苏南通226100 [3]南通大学医学院病理教研室,江苏南通226100

出　　处：《现代肿瘤医学》2022年第13期2369-2373,共5页Journal of Modern Oncology

基　　金：江苏省南通市卫生健康委员会科研课题(编号:QB2019019)。

摘　　要：目的:探讨乳腺癌中间质肿瘤浸润淋巴细胞(TILs)包括CD8^(+)TILs、CD4^(+)TILs、三维淋巴结构(TLS)与临床病理因素和分子亚型的相关性。方法:收集我院2015年至2017年乳腺癌标本200例,经常规石蜡包埋制片,判读HE染色切片间质TLS个数,采用免疫组织化学SP法检测200例病例中CD8^(+)TILs和CD4^(+)TILs浸润密度。结果:乳腺癌间质CD8^(+)TILs、CD4^(+)TILs、TLS与SBR分级、病理TNM分期、Ki67、p53呈正相关;CD8^(+)TILs和CD4^(+)TILs与淋巴结转移呈正相关;与患者年龄呈负相关(均P<0.05)。CD8^(+)TILs和CD4^(+)TILs呈正相关(P<0.05)。TLS以CD4^(+)TILs为主,分别与CD8^(+)TILs和CD4^(+)TILs呈正相关(均P<0.05)。在乳腺癌不同分子亚型中CD8^(+)TILs、CD4^(+)TILs和TLS存在显著差异。结论:乳腺癌中浸润的CD8^(+)TILs、CD4^(+)TILs、TLS反映局部肿瘤微环境的免疫状态,三者密切相关。乳腺癌组织中增多的CD4^(+)TILs诱导CD8^(+)TILs产生CD8^(+)Treg细胞参与乳腺癌的免疫抑制,导致乳腺癌局部免疫功能下降,促进乳腺癌进展及转移。结合乳腺癌分子亚型和局部免疫状态的分析将更有利于预测乳腺癌进展的生物学潜能和对分子靶向性疗效和预后的评估。Objective:To investigate the correlation between tumor infiltrating lymphocytes(TILs)and clinical pathological factors and molecular subtypes in breast cancer,including CD8+TILs,CD4+TILs and tertiary lymphoid structure(TLS).Methods:A total of 200 breast carcinomas were collected from our hospital during 2015 to 2017.Histopathologic analysis of stromal TLS was performed on hematoxylin and eosin-stained sections,and SP immunohisochemical method was used for CD8+TILs and CD4^(+)TILs protein expression.Results:Stromal CD8^(+)TILs,CD4^(+)TILs and TLS were positively correlated with SBR grade,pathological TNM stage,Ki67 and p53.The density of CD8+TILs and CD4+TILs were positively correlated with lymph node metastasis and were negatively correlated with patient age(all P<0.05).The density of CD8^(+)TILs was positively correlated with CD4^(+)TILs(P<0.05).CD4^(+)TILs were the main component of TLS.TLS was positively correlated with CD8^(+)TILs and CD4^(+)TILs(all P<0.05).Significant differences were observed in different molecular subtypes of cancer in CD8^(+)TILs,CD4^(+)TILs and TLS.Conclusion:The infiltration of CD8^(+)TILs,CD4^(+)TILs and TLS in breast cancer reflect the immune status of the local tumor microenvironment,which are closely related.The increase of CD4^(+)TILs in breast cancer,which induce CD8^(+)TILs to produce CD8^(+)Treg cells to participate the immunosuppression of breast cancer,leading to the decline of local immune function of breast cancer,which is beneficial to the progression of breast cancer and lymph node metastasis.Analysis of the combination of breast cancer molecular subtypes and local immune status will be more conducive to predicting the biological potential of breast cancer progression and assessment of molecular targeted efficacy and prognosis.

关 键 词：乳腺浸润性导管癌 CD8^(+)TILs CD4^(+)TILs 三维淋巴结构 分子亚型 临床病理因素 

分 类 号：R737.9[医药卫生—肿瘤]