Welsh Tomas J, Green Ruth H, Richardson Donna, Waller David A, O'Byrne Kenneth J, Bradding Peter
Department of Infection, Immunity, and Inflammation, University of Leicester Medical School, Glenfield Hospital, Leicester, LE3 9QP, United Kingdom.
J Clin Oncol. 2005 Dec 10;23(35):8959-67. doi: 10.1200/JCO.2005.01.4910. Epub 2005 Oct 11.
The role played by the innate immune system in determining survival from non-small-cell lung cancer (NSCLC) is unclear. The aim of this study was to investigate the prognostic significance of macrophage and mast-cell infiltration in NSCLC.
We used immunohistochemistry to identify tryptase+ mast cells and CD68+ macrophages in the tumor stroma and tumor islets in 175 patients with surgically resected NSCLC.
5-year survival was 52.9% in patients with an islet macrophage density greater than the median versus 7.7% when less than the median (P < .0001). In the same groups, respectively, median survival was 2,244 versus 334 days (P < .0001). Patients with a high islet macrophage density but incomplete resection survived markedly longer than patients with a low islet macrophage density but complete resection.
The tumor islet CD68+ macrophage density is a powerful independent predictor of survival from surgically resected NSCLC. The biologic explanation for this and its implications for the use of adjunctive treatment requires further study.
先天性免疫系统在非小细胞肺癌（NSCLC）生存情况的决定中所起的作用尚不清楚。本研究旨在探讨巨噬细胞和肥大细胞浸润在NSCLC中的预后意义。
我们采用免疫组织化学方法，在175例接受手术切除的NSCLC患者的肿瘤基质和肿瘤胰岛中识别类胰蛋白酶阳性肥大细胞和CD68阳性巨噬细胞。
胰岛巨噬细胞密度大于中位数的患者5年生存率为52.9%，而小于中位数的患者为7.7%（P <.0001）。在相同分组中，中位生存期分别为2244天和334天（P <.0001）。胰岛巨噬细胞密度高但切除不完全的患者比胰岛巨噬细胞密度低但切除完全的患者存活时间明显更长。
肿瘤胰岛CD68阳性巨噬细胞密度是手术切除的NSCLC患者生存的有力独立预测指标。对此的生物学解释及其对辅助治疗应用的影响需要进一步研究。
