CAJ | 학술논문

目的研究鼻咽癌组织中肿瘤浸润肥大细胞(tumor-infiltrating mast cells,TIM)的浸润情况,并探讨其与临床分期和预后的关系.方法收集2007年6月至2011年6月在南方医科大学南方医院耳鼻咽喉科确诊和治疗的154例鼻咽癌患者,采用免疫组织化学方法检测鼻咽癌组织中TIM的浸润数量;根据TIM浸润中位数将患者分为高、低密度组,通过Mann-Whitney U检验分析TIM与临床病理因素的相关性.采用Kaplan-Meier法绘制生存曲线,Log-rank检验比较组间生存情况.采用Cox比例风险模型对影响鼻咽癌患者预后的临床因素进行单因素及多因素分析.结果 TIM主要分布于鼻咽癌间质中,在154例鼻咽癌组织中均有浸润,根据TIM中位数(25.60个/高倍视野)将患者分为高密度组(79例)和低密度组(76例).TIM高密度组患者的N分期(Z=-2.193)和临床分期(Z=-2.551)较低密度组晚,差异有统计学意义(P＜0.05).TIM高密度组患者的3年总生存率(64.4％)和无进展生存率(55.7％)均较低密度组(78.3％,77.0％)低,差异有统计学意义(x2=7.791,x2=11.706,P＜0.05).Cox比例风险模型单因素和多因素分析表明,TIM是影响鼻咽癌患者总生存期[相对危险度(RR)=2.023,95％可信区间1.152 ～3.553,P＜0.05)]和无进展生存期的独立危险因素(RR =2.218,95％可信区间1.282 ～3.838,P＜0.05).结论鼻咽癌组织中存在TIM,TIM与患者的N分期和临床分期呈正相关关系,TIM密度与鼻咽癌预后密切相关,TIM密度能否作为预测鼻咽癌患者预后的标志物需要扩大样本进一步研究.
목적 연구비인암조직중종류침윤비대세포(tumor-infiltrating mast cells,TIM)적침윤정황,병탐토기여림상분기화예후적관계.방법 수집2007년6월지2011년6월재남방의과대학남방의원이비인후과학진화치료적154례비인암환자,채용면역조직화학방법검측비인암조직중TIM적침윤수량;근거TIM침윤중위수장환자분위고、저밀도조,통과Mann-Whitney U검험분석TIM여림상병리인소적상관성.채용Kaplan-Meier법회제생존곡선,Log-rank검험비교조간생존정황.채용Cox비례풍험모형대영향비인암환자예후적림상인소진행단인소급다인소분석.결과 TIM주요분포우비인암간질중,재154례비인암조직중균유침윤,근거TIM중위수(25.60개/고배시야)장환자분위고밀도조(79례)화저밀도조(76례).TIM고밀도조환자적N분기(Z=-2.193)화림상분기(Z=-2.551)교저밀도조만,차이유통계학의의(P＜0.05).TIM고밀도조환자적3년총생존솔(64.4％)화무진전생존솔(55.7％)균교저밀도조(78.3％,77.0％)저,차이유통계학의의(x2=7.791,x2=11.706,P＜0.05).Cox비례풍험모형단인소화다인소분석표명,TIM시영향비인암환자총생존기[상대위험도(RR)=2.023,95％가신구간1.152 ～3.553,P＜0.05)]화무진전생존기적독립위험인소(RR =2.218,95％가신구간1.282 ～3.838,P＜0.05).결론 비인암조직중존재TIM,TIM여환자적N분기화림상분기정정상관관계,TIM밀도여비인암예후밀절상관,TIM밀도능부작위예측비인암환자예후적표지물수요확대양본진일보연구.
Objective To investigate the infiltration and prognostic significance of tumor-infiltrating mast cells (TIMs) in nasopharyngeal carcinoma (NPC).Methods Immunohistochemistry for tryptase was performed on 154 NPC specimens.The median value of TIM density was used as a cutoff point to separate the patient cohort into two groups with either low or high TIM infiltration.The associations between TIM and clinicopathological factors were analyzed by Mann-Whitney U text.Survival curves were plotted according to the Kaplan-Meier method.Univariate and multivariate analyses were performed using the Log-rank test and the Cox proportional hazard models,respectively.P ＜ 0.05 was considered statistically significant.All statistical analyses were conducted using SPSS 13.0.Results TIM was mainly in the stroma of NPC and detected in all specimens.The median value of TIM density (25.60/high power field) was used as a cutoff point to separate the patient cohort into two groups with either low or high TIM infiltration.The density of TIM was positively correlated with N stage (Z =-2.193,P ＜ 0.05) and clinical stage (Z =-2.551,P ＜ 0.05).The 3-year overall survival (OS) and progression-free survival (PFS) of patients were 64.4％ and 55.7％ in the high TIM density group;78.3％ and 77.0％ in the low TIM density group.For survival evaluation,high density of TIM was associated with worse OS and PFS (P ＜ 0.05).Multivariate Cox regression model analysis showed TIM infiltration was an independent risk factor for both OS and PFS.Conclusions The density of TIM in NPC increased with tumor stage.High TIM infiltration was associated with poor overall survival and progression-free survival.