中国病理生理杂志
中國病理生理雜誌
중국병리생리잡지
CHINESE JOURNAL OF PATHOPHYSIOLOGY
2015年
1期
160-165
,共6页
肖维华%赵灵灵%应丽丽%马海芬%吴亮%陈国荣
肖維華%趙靈靈%應麗麗%馬海芬%吳亮%陳國榮
초유화%조령령%응려려%마해분%오량%진국영
肺肿瘤%巨噬细胞%极化%预后
肺腫瘤%巨噬細胞%極化%預後
폐종류%거서세포%겁화%예후
KEY WORDS] Lung neoplasms%Macrophages%Polarization%Prognosis
目的:探讨肺腺癌边缘区巨噬细胞M2表型的极化效应、边缘/中心比值及对预后的影响。方法:采用双重免疫组化技术,观察巨噬细胞CD163+/CD68+表型( M2表型)在49例原位肺腺癌( AIS)、11例微小浸润性腺癌( MIA)、57例浸润性腺癌( IA)边缘区及中心区的分布规律和差异,探讨巨噬细胞边缘极化效应及边缘/中心比值在肺腺癌进程中的作用及机制。采用单因素Kaplan-Meier 生存曲线分析及多变量Cox生存分析探讨M2表型边缘极化状态与预后的关系。结果:肺腺癌边缘区M2型巨噬细胞较中心区域呈现极性聚集,具有显著差异(P<0.01)。根据中位数分高、低极化组,低极化组AIS中M2型巨噬细胞计数值与MIA及IA比较未见明显差别,但其在高、极化组AIS中的计数值依次低于MIA和IA,差异有统计学意义(均 P<0.01)。单因素Kaplan-Meier 生存曲线分析及log-rank检验结果显示边缘区巨噬细胞M2表型数量及边缘/中心比值与生存时间呈负相关(礸2=44.71,P<0.01;礸2=21.75,P<0.01)。多变量Cox生存分析表明M2表型边缘高极化状态和边缘/中心比值是独立的预后危险因素( P<0.01)。结论:巨噬细胞M2表型在肺腺癌边缘区存在边缘极化效应,其边缘极化状态和边缘/中心比值是独立的预后危险因素,因此术前穿刺判断边缘极化状态或术后活检检测M2型巨噬细胞型边缘/中心比值可能是评估预后的一种有效方法。
目的:探討肺腺癌邊緣區巨噬細胞M2錶型的極化效應、邊緣/中心比值及對預後的影響。方法:採用雙重免疫組化技術,觀察巨噬細胞CD163+/CD68+錶型( M2錶型)在49例原位肺腺癌( AIS)、11例微小浸潤性腺癌( MIA)、57例浸潤性腺癌( IA)邊緣區及中心區的分佈規律和差異,探討巨噬細胞邊緣極化效應及邊緣/中心比值在肺腺癌進程中的作用及機製。採用單因素Kaplan-Meier 生存麯線分析及多變量Cox生存分析探討M2錶型邊緣極化狀態與預後的關繫。結果:肺腺癌邊緣區M2型巨噬細胞較中心區域呈現極性聚集,具有顯著差異(P<0.01)。根據中位數分高、低極化組,低極化組AIS中M2型巨噬細胞計數值與MIA及IA比較未見明顯差彆,但其在高、極化組AIS中的計數值依次低于MIA和IA,差異有統計學意義(均 P<0.01)。單因素Kaplan-Meier 生存麯線分析及log-rank檢驗結果顯示邊緣區巨噬細胞M2錶型數量及邊緣/中心比值與生存時間呈負相關(礸2=44.71,P<0.01;礸2=21.75,P<0.01)。多變量Cox生存分析錶明M2錶型邊緣高極化狀態和邊緣/中心比值是獨立的預後危險因素( P<0.01)。結論:巨噬細胞M2錶型在肺腺癌邊緣區存在邊緣極化效應,其邊緣極化狀態和邊緣/中心比值是獨立的預後危險因素,因此術前穿刺判斷邊緣極化狀態或術後活檢檢測M2型巨噬細胞型邊緣/中心比值可能是評估預後的一種有效方法。
목적:탐토폐선암변연구거서세포M2표형적겁화효응、변연/중심비치급대예후적영향。방법:채용쌍중면역조화기술,관찰거서세포CD163+/CD68+표형( M2표형)재49례원위폐선암( AIS)、11례미소침윤성선암( MIA)、57례침윤성선암( IA)변연구급중심구적분포규률화차이,탐토거서세포변연겁화효응급변연/중심비치재폐선암진정중적작용급궤제。채용단인소Kaplan-Meier 생존곡선분석급다변량Cox생존분석탐토M2표형변연겁화상태여예후적관계。결과:폐선암변연구M2형거서세포교중심구역정현겁성취집,구유현저차이(P<0.01)。근거중위수분고、저겁화조,저겁화조AIS중M2형거서세포계수치여MIA급IA비교미견명현차별,단기재고、겁화조AIS중적계수치의차저우MIA화IA,차이유통계학의의(균 P<0.01)。단인소Kaplan-Meier 생존곡선분석급log-rank검험결과현시변연구거서세포M2표형수량급변연/중심비치여생존시간정부상관(찰2=44.71,P<0.01;찰2=21.75,P<0.01)。다변량Cox생존분석표명M2표형변연고겁화상태화변연/중심비치시독립적예후위험인소( P<0.01)。결론:거서세포M2표형재폐선암변연구존재변연겁화효응,기변연겁화상태화변연/중심비치시독립적예후위험인소,인차술전천자판단변연겁화상태혹술후활검검측M2형거서세포형변연/중심비치가능시평고예후적일충유효방법。
AIM:To explore the polarized distribution of M 2 macrophages in the marginal region around lung adenocarcinoma , the marginal/central ratio and their effect on the prognosis .METHODS:Double immunohistochemistry staining was used to determine the distribution and the difference of CD 163 +/CD68 +( M2 ) macrophages in the marginal and central regions in 49 cases of lung adenocarcinoma in situ ( AIS), 11 cases of minimally invasive adenocarcinoma ( MIA) and 57 cases of invasive adenocarcinoma ( IA) in order to explore the effect and mechanism of the polarized distri-bution and the marginal/central ratio on the progression of lung adenocarcinoma .Single-factor Kaplan-Meier survival curve analysis and multivariate Cox survival analysis were employed to explore the relationship between the polarized distribution of M2 macrophages and the prognosis .RESULTS:Polarized aggregation of M 2 macrophages was observed in the marginal region of lung adenocarcinoma compared with that in the central region , and the difference was significant ( P<0.01 ) . Based on the median level , they were divided into high polarized group and low polarized group .In low polarized group , M2 macrophage count in AIS was not significantly different from that in MIA or IA .However, in high polarized group, M2 macrophage count in AIS was lower than that in MIA and IA in turn and there were statistically significant differences (P<0.01).Single-factor Kaplan-Meier survival curve analysis and log-rank test result showed that the number of M2 mac-rophages in the marginal region and marginal/central ratio were negatively correlated to the survival time (χ2 =44.71, P<0.01;χ2=21.75, P<0.01).Multivariate Cox survival analysis showed that the high polarized distribution of M 2 macro-phages in the marginal region and the marginal /central ratio were independent risk factors for the prognosis ( P<0.01 ) . CONCLUSION:There is a polarization effect of M2 macrophages on the marginal region of lung adenocarcinoma .The marginal polarization and the marginal/central ratio are independent risk factors of the prognosis .Therefore , it may be an effective method for the evaluation of the prognosis to judge the marginal polarization by preoperative puncture and to deter -mine the marginal/central ratio of M2 macrophages by postoperative biopsy .