CAJ | 학술논문

目的探讨M2型肿瘤相关巨噬细胞(TAMs)浸润程度及肿瘤病理特征与非肌层浸润性膀胱癌(NMIBC)初次复发关系.方法分析337例初次膀胱癌患者临床基本资料,采用免疫组织化学法检测TAMs浸润程度.组间率比较采用x2检验,采用Kaplan-Meier法进行生存分析并采用Log-rank法检验,采用Cox回归单因素和多因素模型对患者预后进行分析.结果在单因素分析中,将癌间质中CD163浸润轻度和中度患者合并,与重度比较,复发率分别为13.4％和74.1％,CD163重度浸润患者复发率明显升高;肿瘤直径大于3 cm和肿瘤直径小于3 cm患者复发率分别为14.0％和28.4％;多发肿瘤和单发肿瘤患者复发率分别为26.7％和14.9％;G1、G2、G3不同肿瘤病理分级复发率分别为25.0％、17.7％和22.1％,差异均有统计学意义(P＜0.05),在Cox回归多因素分析中,肿瘤分级较高、肿瘤直径＞3 cm、多发也与NMIBC复发呈正相关(P＜0.05).结论癌间质中M2型TAMs可以作为NMIBC复发的潜在分子标志物.NMIBC复发危险因素中,肿瘤病理分级、肿瘤大小、CD163间质浸润程度、肿瘤是否单发均为NMIBC复发的独立危险因素,NMIBC复发是多种危险因素的综合作用.
목적 탐토M2형종류상관거서세포(TAMs)침윤정도급종류병리특정여비기층침윤성방광암(NMIBC)초차복발관계.방법 분석337례초차방광암환자림상기본자료,채용면역조직화학법검측TAMs침윤정도.조간솔비교채용x2검험,채용Kaplan-Meier법진행생존분석병채용Log-rank법검험,채용Cox회귀단인소화다인소모형대환자예후진행분석.결과 재단인소분석중,장암간질중CD163침윤경도화중도환자합병,여중도비교,복발솔분별위13.4％화74.1％,CD163중도침윤환자복발솔명현승고;종류직경대우3 cm화종류직경소우3 cm환자복발솔분별위14.0％화28.4％;다발종류화단발종류환자복발솔분별위26.7％화14.9％;G1、G2、G3불동종류병리분급복발솔분별위25.0％、17.7％화22.1％,차이균유통계학의의(P＜0.05),재Cox회귀다인소분석중,종류분급교고、종류직경＞3 cm、다발야여NMIBC복발정정상관(P＜0.05).결론 암간질중M2형TAMs가이작위NMIBC복발적잠재분자표지물.NMIBC복발위험인소중,종류병리분급、종류대소、CD163간질침윤정도、종류시부단발균위NMIBC복발적독립위험인소,NMIBC복발시다충위험인소적종합작용.
Objective To explore the relationship of the infiltration of tumor associated macrophages (TAMs) and tumor pathology with initial recurrence of non-muscle-invasive bladder transitional cell cancer (NMIBC).Methods Diagnostic tissues from 337 patients with NMIBC were evaluated retrospectively by immunohistochemical analysis for CD163.Clinical data and patients' characteristics included age,gender,tumor size,tumor grade,multiplicity and TAMs density.Their correlation between clinicopathological variables and patients' outcome was statistically analyzed with SPSS 21.0 statistical package x2test.Fisher exact t test and Cox regression model were used for multivariate analysis.Kaplan-Meier survival cure and Log-rank test were used to compare the survival rate between different groups with α =0.05as statistical standard.Results We combined the mild infiltration TAMs and moderate infiltration TAMs into the group in tumor stroma,compared with severe infihration group,the recurrence rates are 13.4％,74.1％,respectively.The recurrence rates are 14.0％ for tumor ＜3 cm and 28.4％ for tumor ≥3 cm;26.7％ for multiple tumors and 14.9％ for single tumor;25.0％ for G1 tumor,17.7％ for G2 tumor and 22.1 ％ for G3 tumor,All statistically significant differences were observed.Among all patients,severe infiltration of TAMs in tumor stroma was closely correlated with high recurrence rate (P ＜0.01),whereas for recurrence only tumour grade,size and multiplicity were significantly independent predictors (P ＜0.05 for all).Conclusion TAMs are considered as potential recurrence biomarkers of NMIBC,and high density of TAMs is the initieal recurrence risk factor of NMIBC.