Centre de recherche du CHUM (CRCHUM) and Institut du cancer de Montréal, Montreal, QC, Canada.
Cancer Immunol Immunother. 2010 Sep;59(9):1411-6. doi: 10.1007/s00262-010-0861-x. Epub 2010 May 20.
This report presents a phenotypical characterization of the immune cell infiltrate in a rare case of endobronchial carcinoma. A patient initially treated for an adenocarcinoma of the esophagus developed an endobronchial carcinoma surrounded by gastric metaplasia distal to a suspected gastrobronchial fistula, 11 years after esophagectomy. Our hypothesis is that the sustained exposure of the bronchial mucosa to a mixed acid and pancreatobiliary refluxate led to chronic inflammation and promoted malignant transformation. We performed an immunohistochemical study of the tumor microenvironment evaluating the density of CD3(+), CD8(+) T lymphocytes, CD20(+) B lymphocytes, CD68(+) macrophages and FoxP3(+) regulatory T cells. Quantification of immune cell density was completed using a novel software-based analysis method. Our results suggest that, within all the tissues analyzed, FoxP3(+) regulatory T cells were present at their highest density in the malignant and metaplastic tissues. The endobronchial metaplasia biopsied several years prior to the detection of the endobronchial adenocarcinoma was already densely infiltrated by B cells and macrophages, when compared to the immune cell infiltrate of the endobronchial carcinoma. Altogether, these observations support the current understanding of carcinogenesis promoted by chronic inflammation.
本报告对一例罕见的支气管内癌患者的免疫细胞浸润进行了表型特征描述。一名患者最初被诊断为食管腺癌，在食管切除术后 11 年，因疑似胃支气管瘘而出现远端支气管内癌，伴有胃化生。我们的假设是，支气管黏膜持续暴露于混合胃酸和胰胆反流物中，导致慢性炎症并促进恶性转化。我们对肿瘤微环境进行了免疫组织化学研究，评估了 CD3(+)、CD8(+)T 淋巴细胞、CD20(+)B 淋巴细胞、CD68(+)巨噬细胞和 FoxP3(+)调节性 T 细胞的密度。使用基于新型软件的分析方法完成了免疫细胞密度的定量。我们的结果表明，在所分析的所有组织中，FoxP3(+)调节性 T 细胞在恶性和化生组织中的密度最高。与支气管内腺癌的免疫细胞浸润相比，在支气管内癌检测前几年活检的支气管内化生组织中，B 细胞和巨噬细胞已经密集浸润。综上所述，这些观察结果支持目前对慢性炎症促进癌变的认识。
