结直肠癌中CD66b^(+)肿瘤相关中性粒细胞和促纤维间质反应与临床病理学特征及预后的关系  

CD66b^(+)tumor-associated neutrophils and desmoplastic reaction in colorectal carcinoma and relationship with clinicopathologic features and prognosis

作　　者：张爱 朱宁[1] 杨路路 方媛 王劲松[1] 李俐[1] ZHANG Ai;ZHU Ning;YANG Lulu;FANG Yuan;WANG Jinsong;LI Li(Department of Pathology,Nanjing Medical University Affiliated Nanjing Hospital/Nanjing First Hospital,Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)病理科,南京210006

出　　处：《临床与实验病理学杂志》2024年第4期396-401,共6页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的分析结直肠癌(colorectal cancer,CRC)中CD66b^(+)肿瘤相关中性粒细胞(tumor-associated neutrophils,TANs)和促纤维间质反应(desmoplastic reaction,DR)分类情况,探讨CD66b^(+)TANs和DR在CRC中的临床病理学意义及预后价值。方法采用免疫组化法检测240例CRC中CD66b^(+)TANs的表达数量,应用HE染色切片观察肿瘤间质DR的分类,并分析CD66b^(+)TANs和DR分类与CRC临床病理特征的关系;利用Kaplan-Meier生存曲线分析CD66b^(+)TANs和DR分类与CRC患者预后的关系。结果240例CRC中,CD66b^(+)TANs丰富型(NR)组29例,CD66b^(+)TANs中间型(NI)/缺乏型(NP)组211例;DR分类中,成熟型92例,中间型63例,不成熟型85例。CD66b^(+)TANs NR组与较高的组织学分级(P=0.034)、更晚的TNM分期(P=0.006)和脉管侵犯(P=0.002)均有关。CRC中DR分类与肿瘤分化程度、神经侵犯、淋巴结转移和pTNM分期均密切相关(P<0.05),DR不成熟型CRC分化程度低、有神经侵犯和淋巴结转移、更晚的pTNM分期。Kaplan-Meier生存分析显示,与CD66b^(+)TANs NI/NP CRC患者相比,CD66b^(+)TANs NR CRC患者的3年总生存率明显降低(P<0.05);多因素分析显示:高TANs是CRC的独立预后因素(P<0.05)。DR不成熟型CRC患者的3年总生存率明显低于中间型和成熟型CRC患者(P<0.05)。结论CD66b^(+)TANs和肿瘤间质DR程度均可影响CRC的临床生物学行为,评估CRC中CD66b^(+)TANs和DR有助于预测CRC患者的预后。Purpose To analyze the classification of CD66b^(+)tumor-associated neutrophils(TANs)and desmoplastic reaction(DR)in colorectal cancer(CRC),and to explore the clinicopathological significance and prognostic value of CD66b^(+)TANs and DR in CRC.Methods The expression of CD66b^(+)TANs in 240 CRCs was detected by immunohistochemistry(IHC),and the classification of tumor stromal DR was observed by HE stained sections,and the relationship between CD66b^(+)TANs and DR classification and clinicopathological features was studied.Kaplan-Meier survival curve was used to analyze the relationship between CD66b^(+)TANs and DR and CRC prognosis.Results Among the 240 cases of CRC,29 cases were CD66b^(+)TANs rich(NR)group and 211 cases were CD66b^(+)TANs intermediate(NI)/deficiency(NP)group.In the DR classification,there were 92 cases of mature type,63 cases of intermediate type,and 85 cases of immature type.The CD66b^(+)TANs NR group was associated with higher histological grade(P=0.034),later TNM stage(P=0.006),and vascular invasion(P=0.002).The classification of DR in CRC was closely related to the degree of tumor differentiation,nerve invasion,lymph node metastasis,and pTNM stage,while DR immature type CRC had poorly differentiation,neural invasion,lymph node metastasis,and later pTNM stage(P<0.05).Kaplan-Meier survival analysis showed that the 3-year overall survival(OS)was significantly reduced(P<0.05)in patients with CD66b^(+)TANs NI/NP CRCs compared with CD66b^(+)TANs NI/NP CRC patients.By multivariate analysis,high TANs was an independent prognostic factor(P<0.05).The 3-year overall survival rate of patients with DR-immature CRC was significantly lower than that of patients with intermediate and mature CRC(P<0.05).Conclusion CD66b^(+)TANs and the degree of stromal DR in tumors can affect the clinical and biological behavior of CRC,and evaluating of CD66b^(+)TANs and DR in CRC can help predict the prognosis of CRC patients.

关 键 词：结直肠癌 肿瘤相关中性粒细胞 CD66b 促纤维间质反应 预后 

分 类 号：R735.3[医药卫生—肿瘤]