Zhang Qinglei, Hao Chongli, Cheng Guangzhou, Wang Lei, Wang Xiang, Li Chang, Qiu Juhui, Ding Kejia
Department of Urology, Shandong Provincial Hospital Affiliated to Shandong University Jinan, Shandong, China ; Department of Urology, Tengzhou Central People's Hospital Zaozhuang, Shangdong, China.
Department of Oncology, Tengzhou Central People's Hospital Zaozhuang, Shangdong, China.
Int J Clin Exp Pathol. 2015 Sep 1;8(9):11510-6. eCollection 2015.
The aim of this study was to investigate the clinical significance of CD4(+) T cells in non-muscle-invasive bladder cancer (NMIBC) tissues in situ.
Immunohistochemistry was used to examine the distribution of CD4(+) T cells in 131 NMIBC tissues. Kaplan-Meier analysis and Cox proportional hazards regression models were applied to estimate overall survival (OS) and recurrence-free survival (RFS).
NMIBC patients were divided into two groups based on the median frequency of CD4(+) T cells (median, 1/×400 high resolution). On univariate analysis, CD4(+) T cell density was inversely associated with overall survival (P = 0.01). In those patients with high CD4(+) T density, 5-year OS rates was only 77%, compared with 86% in those with low density, respectively. Although CD4(+) T cell density showed no prognostic significance for RFS (P = 0.36), 5-year RFS rates of patients with high CD4(+) T density (58%) was lower than those of patients with low CD4(+) T density (65%, respectively). By multivariate analysis, tumor infiltrating CD4(+) T cell density emerged as an independent prognostic factor for OS (HR, 2.75; P = 0.004). In addition, no association was found between CD4(+) T cell density and any clinicopathological variables (P > 0.05).
Our findings suggest that CD4(+) T cells could potentially serve as a poor prognostic marker for patients with NMIBC.
本研究旨在探讨非肌层浸润性膀胱癌（NMIBC）组织原位CD4(+) T细胞的临床意义。
采用免疫组织化学法检测131例NMIBC组织中CD4(+) T细胞的分布。应用Kaplan-Meier分析和Cox比例风险回归模型评估总生存期（OS）和无复发生存期（RFS）。
根据CD4(+) T细胞的中位频率（中位值，1/×400高倍视野）将NMIBC患者分为两组。单因素分析显示，CD4(+) T细胞密度与总生存期呈负相关（P = 0.01）。在CD4(+) T细胞密度高的患者中，5年总生存率仅为77%，而密度低的患者为86%。虽然CD4(+) T细胞密度对无复发生存期无预后意义（P = 0.36），但CD4(+) T细胞密度高的患者5年无复发生存率（58%）低于密度低的患者（分别为65%）。多因素分析显示，肿瘤浸润CD4(+) T细胞密度是总生存期的独立预后因素（HR，2.75；P = 0.004）。此外，未发现CD4(+) T细胞密度与任何临床病理变量之间存在关联（P > 0.05）。
我们的研究结果表明，CD4(+) T细胞可能是NMIBC患者预后不良的标志物。
