头颈鳞状细胞癌组织中M2型巨噬细胞与免疫治疗预后的关系  

Expression of M2-type macrophages in head and neck squamous cell carcinoma and prognosis of immunotherapy

作　　者：张宏伟[1] 薛荣 朱兰 赵国平[3] ZHANG Hongwei;XUE Rong;ZHU Lan;ZHAO Guoping(Department of Oral and Maxillofacial Surgery,Tangshan People's Hospital,Tangshan,Hebei,063000,China;School of Basic Medicine,North China University of Science and Technology,Tangshan,Hebei,063000,China;Department of Health Service,Logistics College of Armed Police Force,Tianjin,300162,China)

机构地区：[1]唐山市人民医院口腔颌面外科,河北唐山063000 [2]华北理工大学基础医学院,河北唐山063000 [3]武警后勤学院卫生勤务系,天津300162

出　　处：《中国耳鼻咽喉头颈外科》2025年第2期103-108,共6页Chinese Archives of Otolaryngology-Head and Neck Surgery

摘　　要：目的探究头颈鳞状细胞癌(简称头颈鳞癌)组织中M2型巨噬细胞与免疫治疗预后的关系。方法选择2021年4月~2022年5月在唐山市人民医院接受免疫治疗的165例头颈鳞癌患者为研究对象,根据患者CD163阳性细胞数,分为高表达组(n=75)和低表达组(n=90),分析M2型巨噬细胞表达水平与临床特征的关系。依据患者预后分为死亡组(n=62)和生存组(n=103),采用分层回归模型分析不同临床特征与M2型巨噬细胞的关系,Logistic回归分析M2型巨噬细胞与预后的关系,应用非条件Logistic回归和限制性立方样条模型分析M2型巨噬细胞与死亡的关联及剂量-反应关系,采用Kaplan-Meier生存曲线验证M2型巨噬细胞对患者生存的影响。结果不同肿瘤直径、T分级、N分级、不同肿瘤分化程度、是否淋巴结转移、是否远处转移患者的M2型巨噬细胞表达情况比较,差异均有统计学意义(P<0.05)。死亡组和生存组患者在肿瘤直径、T分级、N分级、肿瘤分化程度、淋巴结转移、远处转移、M2型巨噬细胞表达水平方面的差异有统计学意义(P<0.05)。分层回归分析结果显示肿瘤直径、T分级、N分级、肿瘤分化程度、淋巴结转移、远处转移对M2型巨噬细胞有显著影响(P<0.05)。排除存在共线性的混杂因素后,M2型巨噬细胞表达与死亡存在独立相关性(P<0.05)。M2型巨噬细胞低表达患者1年生存率为82.64%,2年生存率为66.77%,3年生存率为60.28%;M2型巨噬细胞高表达患者1年生存率为60.11%,2年生存率为42.53%,3年生存率为41.82%;两组间均有统计学差异(P<0.05)。结论M2型巨噬细胞与头颈鳞癌患者免疫治疗预后存在独立相关性,M2型巨噬细胞高表达会促进头颈鳞癌的发生发展。OBJECTIVE To investigate the relationship between M2-type macrophages and immunotherapy prognosis in head and neck squamous cell carcinoma.METHODS 165 patients with head and neck squamous cell carcinoma who received immunotherapy in Tangshan People's Hospital from April 2021 to May 2022 were selected as the study objects.According to the number of CD163 positive cells,the patients were divided into high expression group(n=75)and low expression group(n=90),and the relationship between the expression level of M2 macrophages and clinical characteristics was analyzed.Patients were divided into death group(n=62)and survival group(n=103)according to the prognosis.Hierarchical regression model was used to analyze the relationship between different clinical features and M2 macrophages,and Logistic regression was used to analyze the relationship between M2 macrophages and prognosis.The association and dose-response relationship between M2-type macrophages and death were analyzed by unconditional Logistic regression and restricted cubic spline model.The influence of M2-type macrophages on survival was verified by Kaplan-meier survival curve.REULTS The expression of M2 macrophages was compared in patients with different tumor diameters,T grades,N grades,different degrees of tumor differentiation,lymph node metastasis,and distant metastasis,and the differences were statistically significant(P<0.05).The differences in tumor diameter,T grade,N grade,degree of tumor differentiation,lymph node metastasis,distant metastasis,and expression level of M2 macrophages between the death group and survival group were statistically significant(P<0.05).Hierarchical regression analysis showed that tumor diameter,clinical T stage,clinical N stage,degree of tumor differentiation,lymph node metastasis and distant metastasis had significant effects on M2-type macrophages(P<0.05).After the collinear confounding factors were excluded,the expression level of M2-type macrophage was independently correlated with death(P<0.05).The 1-year survival rat

关 键 词：头颈鳞状细胞癌 巨噬细胞 预后 免疫治疗 相关性分析 

分 类 号：R739.91[医药卫生—肿瘤]