Al-Shibli Khalid, Al-Saad Samer, Donnem Tom, Persson Magnus, Bremnes Roy M, Busund Lill-Tove
Department of Pathology, Nordland Central Hospital, Bodo 8092, Norway.
Histopathology. 2009 Sep;55(3):301-12. doi: 10.1111/j.1365-2559.2009.03379.x.
The major value of prognostic markers in potentially curable non-small cell lung carcinoma (NSCLC) should be to guide therapy after surgical resection. The prognostic significance of tumour-infiltrating macrophages, their growth factor, macrophage colony-stimulating factor (M-CSF), and its receptor, colony-stimulating factor-1 receptor (CSF-1R), as well as natural killer cells and dendritic cells, is controversial. The aim of this study was to elucidate the prognostic significance of these markers in the epithelial and stromal compartments of NSCLC.
Tissue microarrays from 335 resected NSCLC, stage I-IIIA were constructed from duplicate cores of epithelial and stromal areas. Immunohistochemistry was used to evaluate epithelial and stromal areas for CD68, M-CSF, CSF-1R, CD56 and CD1a. On univariate analysis, increasing numbers of stromal CD1a+ (P = 0.011) and CD56+ cells (P = 0.014) correlated significantly with improved disease-specific survival (DSS). On multivariate analysis, stromal CD56+ cells were an independent prognostic factor for DSS (hazard ratio = 2.3, confidence interval = 1.1, 5.0, P = 0.031).
High density of stromal CD56+ cells is an independent factor associated with improved prognosis in resected NSCLC, suggesting that these cells mediate an antitumour immune response in the tumour stroma.
在潜在可治愈的非小细胞肺癌(NSCLC)中,预后标志物的主要价值应在于指导手术切除后的治疗。肿瘤浸润巨噬细胞、其生长因子巨噬细胞集落刺激因子(M-CSF)及其受体集落刺激因子-1受体(CSF-1R)以及自然杀伤细胞和树突状细胞的预后意义存在争议。本研究的目的是阐明这些标志物在NSCLC上皮和基质成分中的预后意义。
从335例I-IIIA期切除的NSCLC的上皮和基质区域的重复芯构建组织微阵列。采用免疫组织化学法评估上皮和基质区域的CD68、M-CSF、CSF-1R、CD56和CD1a。单因素分析显示,基质中CD1a+细胞数量增加(P = 0.011)和CD56+细胞数量增加(P = 0.014)与疾病特异性生存率(DSS)显著改善相关。多因素分析显示,基质CD56+细胞是DSS的独立预后因素(风险比 = 2.3,置信区间 = 1.1, 5.0,P = 0.031)。
基质CD56+细胞高密度是与切除的NSCLC预后改善相关的独立因素,提示这些细胞在肿瘤基质中介导抗肿瘤免疫反应。