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M2巨噬细胞浸润至肿瘤胰岛会导致非小细胞肺癌预后不良。

M2 macrophage infiltration into tumor islets leads to poor prognosis in non-small-cell lung cancer.

作者信息

Cao Lili, Che Xiaofang, Qiu Xueshan, Li Zhi, Yang Bowen, Wang Shuo, Hou Kezuo, Fan Yibo, Qu Xiujuan, Liu Yunpeng

机构信息

Department of Medical Oncology, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.

Key Laboratory of Anticancer Drugs and Biotherapy of Liaoning Province, The First Hospital of China Medical University, Shenyang 110001, People's Republic of China.

出版信息

Cancer Manag Res. 2019 Jul 4;11:6125-6138. doi: 10.2147/CMAR.S199832. eCollection 2019.

Abstract

Lung cancer is the leading cause of cancer-related death worldwide. Although the macrophages can affect the development of tumor, the contribution of macrophages to the prognosis of non-small-cell lung cancer (NSCLC) is still controversial. Moreover, anti-PD-1 therapy can redirect macrophages from an M2 to an M1 phenotype, suggesting that tumor PD-L1 may affect the prognostic role of macrophages. Therefore, in this study, we aimed to display a macrophage landscape to clarify the function of macrophages, considering the localization and polarization of the macrophages, and evaluate the effect of M2 macrophages and tumor PD-L1 in combination on the prognosis of NSCLC. We performed multiplex quantitative immunofluorescence staining of pan-cytokeratin (CK), CD68, CD163, PD-L1, and DAPI on one tissue specimen simultaneously from 137 NSCLC patients. M2 macrophages, involved marginM2 (M2 macrophages in tumor stroma), and centralM2 (M2 macrophages infiltrating into tumor islets) increased as the tumor stage increased. More macrophages were found in lung squamous cell carcinoma (LUSC) patients, patients with wild-type EGFR, and smokers than in patients with lung adenocarcinoma (LUAD), patients with EGFR mutations, and non-smokers. Infiltration of centralM2 was an independent prognostic factor of poor overall survival (OS) and disease-free survival (DFS) for NSCLC patients (<0.05), which was superior to total macrophages and total M2 macrophages. Moreover, patients with centralM2PD-L1 tumors showed the best OS and DFS, while the patients with centralM2PD-L1 tumors showed the worst OS and DFS, and the two groups with centralM2PD-L1 and centralM2PD-L1 were in the middle (=0.002, 0.034, respectively). Tumor islet-infiltrating M2 macrophages influence the prognosis of NSCLC patients. The analysis of M2 macrophages and tumor PD-L1 in combination may enhance the accuracy of prognostic prediction. This study provides a new understanding of macrophages in the development of NSCLC through the analysis of macrophage landscape.

摘要

肺癌是全球癌症相关死亡的主要原因。尽管巨噬细胞会影响肿瘤的发展,但巨噬细胞对非小细胞肺癌(NSCLC)预后的影响仍存在争议。此外,抗PD-1疗法可使巨噬细胞从M2表型转变为M1表型,这表明肿瘤PD-L1可能影响巨噬细胞的预后作用。因此,在本研究中,我们旨在描绘巨噬细胞图谱,以阐明巨噬细胞的功能,同时考虑巨噬细胞的定位和极化,并评估M2巨噬细胞和肿瘤PD-L1联合作用对NSCLC预后的影响。我们对137例NSCLC患者的一个组织标本同时进行了全细胞角蛋白(CK)、CD68、CD163、PD-L1和DAPI的多重定量免疫荧光染色。随着肿瘤分期增加,边缘M2巨噬细胞(肿瘤基质中的M2巨噬细胞)和中心M2巨噬细胞(浸润到肿瘤小岛中的M2巨噬细胞)数量增多。与肺腺癌(LUAD)患者、EGFR突变患者和非吸烟者相比,肺鳞状细胞癌(LUSC)患者、野生型EGFR患者和吸烟者体内的巨噬细胞更多。中心M2巨噬细胞浸润是NSCLC患者总生存期(OS)和无病生存期(DFS)较差的独立预后因素(<0.05),其预后价值优于总巨噬细胞和总M2巨噬细胞。此外,中心M2PD-L1肿瘤患者的OS和DFS最佳,而中心M2PD-L1肿瘤患者的OS和DFS最差,中心M2PD-L1和中心M2PD-L1两组患者的OS和DFS处于中间水平(分别为=0.002、0.034)。肿瘤小岛浸润的M2巨噬细胞影响NSCLC患者的预后。联合分析M2巨噬细胞和肿瘤PD-L1可能会提高预后预测的准确性。本研究通过分析巨噬细胞图谱,为NSCLC发生发展过程中的巨噬细胞提供了新的认识。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ce6e/6613613/35498f9c96dc/CMAR-11-6125-g0001.jpg

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