Modi Jitu, Patel Aneeta, Terrell Richard, Tuttle R Michael, Francis Gary L
Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, Maryland 20814, USA.
J Clin Endocrinol Metab. 2003 Sep;88(9):4418-25. doi: 10.1210/jc.2003-030342.
The immune response appears to be important in preventing metastasis and recurrence of thyroid cancer. We previously showed that papillary thyroid carcinoma (PTC) from children and adolescents that contain the most numerous proliferating lymphocytes have the best prognosis. However, the types of lymphocytes involved are not yet known. To further define this, we examined 21 PTCs from patients 21 yr of age or younger (52% were 18-21 yr of age) for the presence of CD4+ (helper), CD8+ (killer), CD19+ (B cells), and CD56+ (natural killer) cells as well as proliferating lymphocytes (Ki-67+). Nearly half the PTCs contained CD4+ (9 of 21, 43%), CD8+ (8 of 21, 38%), or CD19+ (10 of 21, 48%) lymphocytes. Only one PTC (1 of 21, 5%) contained CD56+ lymphocytes, and none contained all four cell types. By dual staining, none of these lymphocytes were proliferating (Ki-67+). However, PTCs containing either CD8+ cells (n = 8) or a combination of CD4+, CD8+, and CD19+ cells (n = 5) contained more numerous proliferating lymphocytes than did PTCs containing any other combination (14.2-fold increase, P = 0.03 and 13.1-fold increase, P = 0.003, respectively). During follow-up, none of the PTCs containing either CD8+ lymphocytes or the combination of CD4+, CD8+, and CD19+ lymphocytes recurred. However, the cohort is too small and the follow-up inadequate to provide accurate information on the clinical impact of these immunological findings. We conclude that the immune response against PTC is important and also complex, involving more than one type of lymphocyte.
免疫反应在预防甲状腺癌转移和复发方面似乎很重要。我们之前表明，儿童和青少年的乳头状甲状腺癌（PTC）中增殖淋巴细胞数量最多，其预后最佳。然而，所涉及的淋巴细胞类型尚不清楚。为了进一步明确这一点，我们检查了21例21岁及以下患者的PTC（52%为18 - 21岁），以检测CD4 +（辅助性）、CD8 +（杀伤性）、CD19 +（B细胞）和CD56 +（自然杀伤）细胞以及增殖淋巴细胞（Ki - 67 +）的存在情况。近一半的PTC含有CD4 +（21例中的9例，43%）、CD8 +（21例中的8例，38%）或CD19 +（21例中的10例，48%）淋巴细胞。只有1例PTC（21例中的1例，5%）含有CD56 +淋巴细胞，且没有PTC含有所有四种细胞类型。通过双重染色，这些淋巴细胞均未增殖（Ki - 67 +）。然而，含有CD8 +细胞的PTC（n = 8）或含有CD4 +、CD8 +和CD19 +细胞组合的PTC（n = 5）比含有任何其他组合的PTC含有更多的增殖淋巴细胞（分别增加14.2倍，P = 0.03和增加13.1倍，P = 0.003）。在随访期间，含有CD8 +淋巴细胞或CD4 +、CD8 +和CD19 +淋巴细胞组合的PTC均未复发。然而，该队列规模太小且随访不足，无法提供有关这些免疫学发现临床影响的准确信息。我们得出结论，针对PTC的免疫反应很重要且复杂，涉及不止一种类型的淋巴细胞。
