中华临床医师杂志（电子版）
中華臨床醫師雜誌（電子版）
중화림상의사잡지（전자판）
CHINESE JOURNAL OF CLINICIANS(ELECTRONIC VERSION)
2013年
24期
11272-11276
,共5页
高铭%李济宇%欧敬民%朱松明
高銘%李濟宇%歐敬民%硃鬆明
고명%리제우%구경민%주송명
免疫微环境%T淋巴细胞,调节性%淋巴细胞,肿瘤浸润%胃癌术后%生存期
免疫微環境%T淋巴細胞,調節性%淋巴細胞,腫瘤浸潤%胃癌術後%生存期
면역미배경%T림파세포,조절성%림파세포,종류침윤%위암술후%생존기
Immune microenvironment%T-Lymphocytes,regulatory%Lymphocytes,tumor-infiltrating%Gastric cancer after radical resection%Survival
目的：检测胃癌患者肿瘤、瘤旁、正常胃壁组织（瘤旁7～8 cm）Treg细胞和多种免疫细胞密度及功能状况，分析其与患者临床病理和预后的关系。方法采用免疫组织化学方法检测200例胃癌手术患者肿瘤、瘤旁1 cm、瘤旁正常胃壁组织中Treg细胞和多种免疫细胞密度及功能状况，利用多种统计学方法，了解 Treg 细胞与多种免疫细胞间的关系及其与患者临床病理和预后的关系。结果（1）胃癌肿瘤中Treg细胞和CD3、CD4、CD8、NK细胞、DC阳性细胞的平均浸润数目高于正常胃壁组织（P≤0.05），而肿瘤与瘤旁1 cm之间的免疫细胞数目无统计学差异（P≥0.05）。（2）在肿瘤组织中CD8、NK细胞、DC 阳性细胞低浸润组较之高浸润组在区域淋巴结转移方面有统计学差异（P＜0.05），但对肿瘤的复发转移和总生存期无明显影响。（3）在肿瘤组织中Treg细胞低浸润组较之高浸润组在TNM分期高低（P＞0.001），肿瘤复发转移（P＝0.048）和生存情况（P＝0.021）有统计学差异。Cox单因素（P＝0.012）和多因素生存分析（P＝0.0035）提示Treg是胃癌患者独立预后因素。结论在胃癌肿瘤局部聚集着比正常组织内更多的各类免疫细胞，其中CD8、NK细胞、DC细胞在肿瘤局部更高的浸润度可以减少区域淋巴结转移，但对患者最终预后无影响；真正对胃癌预后生存有影响的是肿瘤组织中Treg细胞的浸润情况。它可以作为胃癌抗肿瘤免疫治疗的靶点。
目的：檢測胃癌患者腫瘤、瘤徬、正常胃壁組織（瘤徬7～8 cm）Treg細胞和多種免疫細胞密度及功能狀況，分析其與患者臨床病理和預後的關繫。方法採用免疫組織化學方法檢測200例胃癌手術患者腫瘤、瘤徬1 cm、瘤徬正常胃壁組織中Treg細胞和多種免疫細胞密度及功能狀況，利用多種統計學方法，瞭解 Treg 細胞與多種免疫細胞間的關繫及其與患者臨床病理和預後的關繫。結果（1）胃癌腫瘤中Treg細胞和CD3、CD4、CD8、NK細胞、DC暘性細胞的平均浸潤數目高于正常胃壁組織（P≤0.05），而腫瘤與瘤徬1 cm之間的免疫細胞數目無統計學差異（P≥0.05）。（2）在腫瘤組織中CD8、NK細胞、DC 暘性細胞低浸潤組較之高浸潤組在區域淋巴結轉移方麵有統計學差異（P＜0.05），但對腫瘤的複髮轉移和總生存期無明顯影響。（3）在腫瘤組織中Treg細胞低浸潤組較之高浸潤組在TNM分期高低（P＞0.001），腫瘤複髮轉移（P＝0.048）和生存情況（P＝0.021）有統計學差異。Cox單因素（P＝0.012）和多因素生存分析（P＝0.0035）提示Treg是胃癌患者獨立預後因素。結論在胃癌腫瘤跼部聚集著比正常組織內更多的各類免疫細胞，其中CD8、NK細胞、DC細胞在腫瘤跼部更高的浸潤度可以減少區域淋巴結轉移，但對患者最終預後無影響；真正對胃癌預後生存有影響的是腫瘤組織中Treg細胞的浸潤情況。它可以作為胃癌抗腫瘤免疫治療的靶點。
목적：검측위암환자종류、류방、정상위벽조직（류방7～8 cm）Treg세포화다충면역세포밀도급공능상황，분석기여환자림상병리화예후적관계。방법채용면역조직화학방법검측200례위암수술환자종류、류방1 cm、류방정상위벽조직중Treg세포화다충면역세포밀도급공능상황，이용다충통계학방법，료해 Treg 세포여다충면역세포간적관계급기여환자림상병리화예후적관계。결과（1）위암종류중Treg세포화CD3、CD4、CD8、NK세포、DC양성세포적평균침윤수목고우정상위벽조직（P≤0.05），이종류여류방1 cm지간적면역세포수목무통계학차이（P≥0.05）。（2）재종류조직중CD8、NK세포、DC 양성세포저침윤조교지고침윤조재구역림파결전이방면유통계학차이（P＜0.05），단대종류적복발전이화총생존기무명현영향。（3）재종류조직중Treg세포저침윤조교지고침윤조재TNM분기고저（P＞0.001），종류복발전이（P＝0.048）화생존정황（P＝0.021）유통계학차이。Cox단인소（P＝0.012）화다인소생존분석（P＝0.0035）제시Treg시위암환자독립예후인소。결론재위암종류국부취집착비정상조직내경다적각류면역세포，기중CD8、NK세포、DC세포재종류국부경고적침윤도가이감소구역림파결전이，단대환자최종예후무영향；진정대위암예후생존유영향적시종류조직중Treg세포적침윤정황。타가이작위위암항종류면역치료적파점。
Objective To obtain results about the relationship between Treg cells and a variety of immune cells with the clinical pathology and prognosis, We detected tumor, normal gastric tissues, adjacent to the tumor and in patients with gastric cancer and investigated the density, position and function about Treg cells and a variety of immune cell. Methods The 200 cases was detected by immunohistochemical method with tumor, peritumoral 1 cm, normal gastric tissues and for density and function about Treg cells and a variety of immune cell.Through statistical methods of t test, chi-square test, Cox survival analysis, we understand the relationship between Treg cells and a variety of immune cells with clinical pathology and prognosis. Results (1)The average number of gastric cancer tumor infiltration of Treg cells and CD3, CD4, CD8, NK cells, DC positive cells was higher than that of 7-8 cm (normal gastric tissues adjacent to the tumor) (P≤0.05), but there was no difference between the number of tumors and adjacent 1cm immune cells (P≥0.05). (2)CD8, NK cells and DC positive cells with low infiltration group in the tumor tissue have significant difference in the regional lymph node metastasis than in the high infiltration group(P<0.05), but had no significant effect on recurrence and overall survival. (3)In the tumor tissue, between Treg cells with low infiltration group and high infiltration group, there were significant differences in the TNM stage(P>0.001), recurrence and metastasis of tumor (P=0.048) and survival(P=0.021). Single(P=0.012) and multivariate Cox survival analysis(P=0.0035) indicated that the Treg was the independent prognostic factor. Conclusions In the gastric tumor, there were more various types of immune cells than in normal tissues, including higher infiltration of CD8, NK cells and DC cells .They can reduce regional lymph node metastasis, but had no effect on the final outcome for the patient.The real impact on the prognosis of gastric cancer survival is the infiltration of Treg cells in tumor tissue.It can be as targets for cancer immunotherapy against tumors.
