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[细胞毒性淋巴细胞在乳腺癌及引流淋巴结中的临床病理意义]

[Clinicopathological significance of cytotoxic lymphocytes in breast cancer and draining lymph nodes].

作者信息

Wang Hong-Yan, He Jian-Jun, Shi Qin-Feng, Lai Bao-Chang, Ding Hai-Yan, Zheng Jin, Wang Yi-Li

机构信息

Center for Cancer Research, the First Affiliated Hospital, Xi'an Jiaotong University, Xi'an 710061, China.

出版信息

Zhonghua Bing Li Xue Za Zhi. 2009 Jun;38(6):384-8.

Abstract

OBJECTIVE

To analyze retrospectively the quantity and activation status of the tumor infiltrating cytotoxic lymphocytes in breast cancer and the draining lymph nodes, and its relation to the clinical pathological significance.

METHODS

Seventy-four breast cancer samples with their corresponding axillary lymph nodes were histologically typed and staged. Cytotxic lymphocytes were analyzed by immunohistochemistry with the monoclonal antibodies against CD8, CD56, granzyme B and perforin.

RESULTS

The number of infiltrating CD8(+) T cells in the cancerous interstitial tissue were much higher than that in the tumor parenchyma. Compared with the metastatic tumor samples, the CD8(+) T cells were more intensive in the primary tumors (35.7 +/- 16.0 vs. 23.7 +/- 9.6). The tumor infiltrating CD8(+) T cells of patients with 5 years survivals were more than that of the dead cases in this follow-up series death (32.9 +/- 14.1 vs. 20.1 +/- 9.9). There was no significant difference of activated tumor infiltrating cytotoxic T cell analyzed by using the activation marker granzyme B(+) and there was also no significant correlation between the intensity of CD8(+), CD56(+) cells and the clinicopathological stages. However, percentages of the activated cytotoxic lymphocytes in Stage I groups were significantly higher than those in stage III and IV. Moreover, the number of perforin(+) cells was significantly less than that of granzyme B(+) cells, particularly in the cancerous tissue, indicating a dysfunctional status of tumor infiltrating cytotoxic lymphocytes.

CONCLUSIONS

Activated cytotoxic lymphocytes may play a significant role against the tumor progression and is associated with a favorable prognosis to some extent. However, a putative dysfunctional status of cytotoxic lymphocytes at tumor site may compromise the host immunity against cancer.

摘要

目的

回顾性分析乳腺癌及其引流淋巴结中肿瘤浸润性细胞毒性淋巴细胞的数量和活化状态,及其与临床病理意义的关系。

方法

对74例乳腺癌样本及其相应腋窝淋巴结进行组织学分型和分期。采用抗CD8、CD56、颗粒酶B和穿孔素的单克隆抗体,通过免疫组织化学分析细胞毒性淋巴细胞。

结果

癌间质组织中浸润的CD8(+) T细胞数量远高于肿瘤实质。与转移瘤样本相比,原发性肿瘤中CD8(+) T细胞更密集(35.7±16.0对23.7±9.6)。在该随访系列死亡病例中,生存5年患者的肿瘤浸润CD8(+) T细胞多于死亡病例(32.9±14.1对20.1±9.9)。使用活化标志物颗粒酶B(+)分析活化的肿瘤浸润性细胞毒性T细胞无显著差异,CD8(+)、CD56(+)细胞强度与临床病理分期之间也无显著相关性。然而,I期组活化细胞毒性淋巴细胞的百分比显著高于III期和IV期。此外,穿孔素(+)细胞数量显著少于颗粒酶B(+)细胞,尤其是在癌组织中,表明肿瘤浸润性细胞毒性淋巴细胞存在功能失调状态。

结论

活化的细胞毒性淋巴细胞可能在对抗肿瘤进展中发挥重要作用,并在一定程度上与良好预后相关。然而,肿瘤部位细胞毒性淋巴细胞的假定功能失调状态可能会损害宿主对癌症的免疫力。

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