CAJ | 학술논문

目的探讨皮肤恶性黑素瘤标本肿瘤相关巨噬细胞(TAM)浸润情况与肿瘤临床病理特征及上皮间质化指标之间的关系.方法收集54例皮肤黑素瘤及15例良性色素痣石蜡标本,用免疫组化法对TAM标记CD163及上皮间质化指标上皮型钙黏蛋白、神经型钙黏蛋白及波形蛋白在组织中的表达进行检测.采用SPSS 17.0统计软件进行数据分析,计量资料(x)±s表示,采用t检验、单因素方差分析、多因素线性回归进行数据分析.结果恶性黑素瘤标本中检测到CD163阳性的TAM,在色素痣标本中未发现明显的CD163阳性细胞.在原位黑素瘤中,TAM计数为16.97±8.74,在侵袭性黑素瘤中,TAM计数为35.08±13.78,差异有统计学意义(P＜0.05).在有淋巴结转移的TAM计数为56.00±3.07,在无淋巴结转移的TAM计数为28.70±18.52,差异有统计学意义(P＜0.05).TAM计数在Clark分级中差异有统计学意义(P＜0.05),且在Ⅰ～Ⅳ级TAM计数随Clark级别增高而增加,Ⅳ级与Ⅴ级之间的TAM计数,差异无统计学意义(P＞0.05).TAM计数在不同性别、不同年龄、肢端/非肢端、是否溃疡之间比较,差异无统计学意义(P≥0.05).多因素线性回归结果显示,皮肤恶性黑素瘤组织中,TAM计数与Clark分级、溃疡、肿瘤进展、神经型钙黏蛋白及波形蛋白5个因素相关.结论皮肤恶性黑素瘤中TAM可能通过促进上皮间质化使肿瘤发展,从而增加肿瘤的恶性程度.
목적 탐토피부악성흑소류표본종류상관거서세포(TAM)침윤정황여종류림상병리특정급상피간질화지표지간적관계.방법 수집54례피부흑소류급15례량성색소지석사표본,용면역조화법대TAM표기CD163급상피간질화지표상피형개점단백、신경형개점단백급파형단백재조직중적표체진행검측.채용SPSS 17.0통계연건진행수거분석,계량자료(x)±s표시,채용t검험、단인소방차분석、다인소선성회귀진행수거분석.결과 악성흑소류표본중검측도CD163양성적TAM,재색소지표본중미발현명현적CD163양성세포.재원위흑소류중,TAM계수위16.97±8.74,재침습성흑소류중,TAM계수위35.08±13.78,차이유통계학의의(P＜0.05).재유림파결전이적TAM계수위56.00±3.07,재무림파결전이적TAM계수위28.70±18.52,차이유통계학의의(P＜0.05).TAM계수재Clark분급중차이유통계학의의(P＜0.05),차재Ⅰ～Ⅳ급TAM계수수Clark급별증고이증가,Ⅳ급여Ⅴ급지간적TAM계수,차이무통계학의의(P＞0.05).TAM계수재불동성별、불동년령、지단/비지단、시부궤양지간비교,차이무통계학의의(P≥0.05).다인소선성회귀결과현시,피부악성흑소류조직중,TAM계수여Clark분급、궤양、종류진전、신경형개점단백급파형단백5개인소상관.결론 피부악성흑소류중TAM가능통과촉진상피간질화사종류발전,종이증가종류적악성정도.
Objective To investigate the relationship of tumor-associated macrophage (TAM) infiltration in lesions with clinicopathologic features of cutaneous malignant melanoma (CMM) and epithelialmesenchymal transition (EMT)-related indicators.Methods Fifty-four CMM and 15 benign melanocytic nevus paraffin-embedded tissue samples were collected.An immunohistochemical study was performed to determine the expression pattern and intensity of the TAM marker CD163 as well as EMT indicators epithelial cadherin (E-cadherin),neurologic cadherin (N-cadherin) and vimentin in these tissue samples.Count data were expressed as mean ± standard deviation.Statistical analysis was carried out using t test,one-way analysis of variance (ANOVA) and multivariate linear regression analysis with the software SPSS 17.0.Results CD163-positive TAMs were detected in CMM samples,but not in benign melanocytic nevus samples.The mean TAM count per high power field in tissue samples was significantly different between invasive and in situ CMM (35.08 ± 13.78 vs.16.97 ± 8.74,P ＜ 0.05),and between melanoma with lymph node metastasis and that without (56.00 ± 3.07 vs.28.70 ± 18.52,P ＜ 0.05),and among melanoma with different Clark levels (P ＜ 0.05).Additionally,the mean TAM count increased with the increase in Clark level from Ⅰ to Ⅳ,but was insignificantly different between Clark level Ⅳ and Ⅴ (P ＞ 0.05).No significant difference was observed in TAM count between patients of different gender or age groups,between acral and non-acral melanoma,or between ulcerated and non-ulcerated melanoma (all P ≥ 0.05).Multivariate linear regression analysis showed that TAM count in CMM was associated with five factors:Clark level,ulceration,tumor progression,N-cadherin and vimentin.Conclusion TAMs may accelerate tumor progression and increase tumor malignancy by promoting EMT in CMM.