CAJ | 학술논문

目的：探讨CD8＋淋巴细胞浸润与乳腺癌临床病理特征及预后的关系。方法回顾性分析2000年1月至2008年12月中山大学肿瘤防治中心收治的681例可手术切除的乳腺癌患者的临床资料，用组织芯片免疫组化法检测乳腺癌原发灶中CD8＋淋巴细胞浸润情况，分析其与乳腺癌临床病理特征及预后的关系。结果42．0％（286/681）的乳腺癌间质存在CD8＋淋巴细胞高浸润。 CD8＋淋巴细胞浸润与乳腺癌患者的年龄、月经情况、肿瘤大小、淋巴结转移、病理分期、脉管癌栓、组织学分级、激素受体表达、HER-2表达有关（ P＜0．05）。全组患者的5年无病生存率和5年生存率分别为79．2％和87．6％；其中CD8＋淋巴细胞高浸润者与低浸润者的5年无病生存率分别为83．2％和68．8％，5年生存率分别为89．5％和82．2％，差异均有统计学意义（ P＜0．05）。 Cox多因素分析显示，CD8＋淋巴细胞浸润是影响患者无病生存和总生存的独立预后因素。结论 CD8＋淋巴细胞浸润可作为预测可手术乳腺癌预后的一个指标。
목적：탐토CD8＋림파세포침윤여유선암림상병리특정급예후적관계。방법회고성분석2000년1월지2008년12월중산대학종류방치중심수치적681례가수술절제적유선암환자적림상자료，용조직심편면역조화법검측유선암원발조중CD8＋림파세포침윤정황，분석기여유선암림상병리특정급예후적관계。결과42．0％（286/681）적유선암간질존재CD8＋림파세포고침윤。 CD8＋림파세포침윤여유선암환자적년령、월경정황、종류대소、림파결전이、병리분기、맥관암전、조직학분급、격소수체표체、HER-2표체유관（ P＜0．05）。전조환자적5년무병생존솔화5년생존솔분별위79．2％화87．6％；기중CD8＋림파세포고침윤자여저침윤자적5년무병생존솔분별위83．2％화68．8％，5년생존솔분별위89．5％화82．2％，차이균유통계학의의（ P＜0．05）。 Cox다인소분석현시，CD8＋림파세포침윤시영향환자무병생존화총생존적독립예후인소。결론 CD8＋림파세포침윤가작위예측가수술유선암예후적일개지표。
Objective To investigate the prognostic value and clinicopathological characteristics of tumor-infiltrating CD8+lymphocytes in operable breast cancer. Methods Paraffin sections were retrospectively collected from 681 cases of operable breast cancer patients from January 2000 to December 2008 in Cancer Center of Sun Yat-sen Unversity. Immunohistochemical staining of tissue microarray were used to assess the density of tumor-infiltrating CD8+ lymphocytes. The number of CD8+ lymphocytes counted in tumor stroma, and the relationship with clinical outcome and clinicopathological characteristics was determined. Results The propor-tion of high infiltrating CD8+ lymphocytes was 42. 0%( 286/681) in interstitial tissues of breast cancer. The infiltrating CD8+ lympho-cytes were related to age at diagnosis, menstruation, tumor size, lymph node metastasis, pathological stage, lymphovascular invasion, histological grade, hormone receptor status and HER-2 status( P<0. 05) . The 5-year disease-free survival rate and 5-year overall sur-vival rate in the whole patients were 79. 2% and 87. 6%, respectively. The 5-year disease-free survival rate of patients with high and low tumor-infiltrating CD8+ lymphocytes were 83. 2% and 68. 8%, the 5-year overall survival rate were 89. 5% and 82. 2%. The high tumor-infiltrating CD8+lymphocytes were associated with better survival( P<0. 05) . In multivariate analysis, the number of CD8+lym-phocytes was an independent prognostic factor influencing disease-free survival and overall survival. Conclusion Infiltrating CD8+lymphocytes may become a prognositic predictor for operable breast cancer.