Shabtai M, Ye H, Frischer Z, Martin J, Waltzer W C, Malinowski K
Department of Surgery, State University of New York at Stony Brook, Stony Brook, USA.
J Urol. 2002 Nov;168(5):2216-9. doi: 10.1016/S0022-5347(05)64358-3.
As manifested by the presence of immune competent cells, failure to control the progression of renal cell carcinoma by a local immune response attests to impaired local cell mediated immunity. To test this hypothesis we compared the expression of T-cell activation markers in renal cell carcinoma infiltrating lymphocytes with the expression of activation markers of peripheral blood lymphocytes in the same patients.
Tumor infiltrating lymphocytes were harvested from a patient with renal cell carcinoma undergoing radical nephrectomy. Peripheral blood was obtained before surgery. Tumor infiltrating and peripheral blood lymphocytes were incubated with monoclonal antibodies defining specific differentiation and activation markers on the cell surface, and analyzed by flow cytometry. Cell subsets are expressed as a fraction of the total number of mononuclear cells.
The T-cell subset level was significantly higher in peripheral blood than in renal cell carcinoma tissue of the same patient. However, the level of activated T-cell subset expressing HLA-DR was significantly higher in renal cell carcinoma tissue than in peripheral blood. The levels of interleukin-2 receptor and transferrin receptors expressing T-cell subsets were also significantly higher in carcinoma tissue than in peripheral blood. Natural killer cells were found in significantly higher proportions in renal cell carcinoma than in peripheral blood.
These results point to significant activation of T, B and natural killer tumor infiltrating lymphocytes. The inability of tumor infiltrating lymphocytes to mount an effective immune response to renal cell carcinoma may be secondary to the presence of suppressive factors in the tumor that prevent tumor infiltrating lymphocytes from transforming into effector cells. These factors may be particularly valuable for the further study of renal cell carcinoma-host interactivity.
通过免疫活性细胞的存在可表明,局部免疫反应未能控制肾细胞癌的进展,这证明局部细胞介导的免疫功能受损。为验证这一假设,我们比较了肾细胞癌浸润淋巴细胞中T细胞活化标志物的表达与同一患者外周血淋巴细胞活化标志物的表达。
从一名接受根治性肾切除术的肾细胞癌患者身上采集肿瘤浸润淋巴细胞。术前采集外周血。将肿瘤浸润淋巴细胞和外周血淋巴细胞与定义细胞表面特定分化和活化标志物的单克隆抗体一起孵育,并通过流式细胞术进行分析。细胞亚群以单核细胞总数的比例表示。
同一患者外周血中的T细胞亚群水平显著高于肾细胞癌组织中的T细胞亚群水平。然而,表达HLA-DR的活化T细胞亚群水平在肾细胞癌组织中显著高于外周血。表达白细胞介素-2受体和转铁蛋白受体的T细胞亚群水平在癌组织中也显著高于外周血。肾细胞癌中自然杀伤细胞的比例显著高于外周血。
这些结果表明肿瘤浸润的T、B淋巴细胞和自然杀伤细胞有显著活化。肿瘤浸润淋巴细胞无法对肾细胞癌产生有效的免疫反应,可能是由于肿瘤中存在抑制因子,阻止肿瘤浸润淋巴细胞转化为效应细胞。这些因子对于进一步研究肾细胞癌与宿主的相互作用可能特别有价值。