CAJ | 학술논문

目的分析乳腺癌原发灶组织和腋淋巴结中细胞毒性淋巴细胞的数量和状态,并与乳腺癌临床病理特征相比较,探讨其意义.方法对资料齐全且术前均未接受任何化疗和放疗的74例乳腺癌原发灶及所切除的腋淋巴结进行病理分型及临床病理分期,并分为淋巴结无转移组和有转移组.采用免疫组织化学催化信号放大系统和EnVision法,通过单克隆抗体CD8、粒酶B、穿孔素、CD56的检测,分析肿瘤原发灶及腋淋巴结中细胞毒性淋巴细胞的表型和功能.结果在肿瘤原发灶组织中CD8+细胞间质明显多于实质,淋巴结无转移组肿瘤局部[(35.7±16.0)个]及腋淋巴结CD8+细.胞数[(53.0±18.2)个]均高于淋巴结有转移组[(23.7±9.6)个和(38.2±12.7)个],肿瘤原发灶CD8+细胞数在5年生存组[(32.9±14.1)个]显著高于死亡组[(20.1±9.9)个].以粒酶B为细胞毒性淋巴细胞活化标记时,细胞毒性淋巴细胞的百分率差异无统计学意义;肿瘤组织和腋淋巴结中CD8+、CD56+细胞数均与临床病理分期无关.与Ⅰ期相比,在Ⅲ+Ⅳ期原发灶组织和腋淋巴结中细胞毒性淋巴细胞的数量显著降低.值得注意的是,在多数情况下,原发灶组织中穿孔素+细胞数量明显低于粒酶B+细胞.结论在乳腺癌中细胞毒性淋巴细胞对抑制其肿瘤转移、提高患者生存率有一定意义.组织中细胞毒性淋巴细胞功能缺陷可能是影响其发挥抗瘤效应的重要因素.
목적 분석유선암원발조조직화액림파결중세포독성림파세포적수량화상태,병여유선암림상병리특정상비교,탐토기의의.방법 대자료제전차술전균미접수임하화료화방료적74례유선암원발조급소절제적액림파결진행병리분형급림상병리분기,병분위림파결무전이조화유전이조.채용면역조직화학최화신호방대계통화EnVision법,통과단극륭항체CD8、립매B、천공소、CD56적검측,분석종류원발조급액림파결중세포독성림파세포적표형화공능.결과 재종류원발조조직중CD8+세포간질명현다우실질,림파결무전이조종류국부[(35.7±16.0)개]급액림파결CD8+세.포수[(53.0±18.2)개]균고우림파결유전이조[(23.7±9.6)개화(38.2±12.7)개],종류원발조CD8+세포수재5년생존조[(32.9±14.1)개]현저고우사망조[(20.1±9.9)개].이립매B위세포독성림파세포활화표기시,세포독성림파세포적백분솔차이무통계학의의;종류조직화액림파결중CD8+、CD56+세포수균여림상병리분기무관.여Ⅰ기상비,재Ⅲ+Ⅳ기원발조조직화액림파결중세포독성림파세포적수량현저강저.치득주의적시,재다수정황하,원발조조직중천공소+세포수량명현저우립매B+세포.결론 재유선암중세포독성림파세포대억제기종류전이、제고환자생존솔유일정의의.조직중세포독성림파세포공능결함가능시영향기발휘항류효응적중요인소.
Objective To analyze retrospectively the quantity and activation status of the tumor infiltrating cytotoxic lymphocytes in breast cancer and the draining lymph nodes, and its relation to the clinical pathological significance.Methods Seventy-four breast cancer samples with their corresponding axillary lymph nodes were histologically typed and staged.Cytotxic lymphocytes were analyzed by immunohistocbemistry with the monoclonal antibodies against CD8, CD56, granzyme B and perforin.Results The number of infiltrating CD8+ T cells in the cancerous interstitial tissue were much higher than that in the tumor parenchyma.Compared with the metastatic tumor samples, the CD8 + T cells were more intensive in the primary tumors ( 35.7 ± 16.0 vs.23.7 ± 9.6 ).The tumor infiltrating CD8+ T cells of patients with 5 years survivals were more than that of the dead cases in this follow-up series death ( 32.9 ± 14.1 vs.20.1 ± 9.9 ).There was no significant difference of activated tumor infiltrating cytotoxic T cell analyzed by using the activation marker granzyme B+ and there was also no significant correlation between the intensity of CD8+,CD56+ cells and the clinicopathological stages.However, percentages of the activated cytotoxic lymphocytes in Stage Ⅰ groups were significantly higher than those in stage Ⅲ and Ⅳ.Moreover, the number of perforin+ cells was significantly less than that of granzyme B+ cells, particularly in the cancerous tissue, indicating a dysfunctional status of tumor infiltrating cytotoxic lymphocytes.Conclusions Activated cytotoxic lymphocytes may play a significant role against the tumor progression and is associated with a favorable prognosis to some extent.However, a putative dysfunctional status of cytotoxic lymphocytes at tumor site may compromise the host immunity against cancer.