Whelchel J C, Farah S E, McLean I W, Burnier M N
Department of Ophthalmic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306-6000.
Invest Ophthalmol Vis Sci. 1993 Jul;34(8):2603-6.
To investigate using immunohistochemistry the unusual finding that tumor infiltrating lymphocytes (TIL) in uveal melanomas are associated with a higher mortality rate.
We performed immunohistochemistry for B and T lymphocytes on 80 uveal malignant melanomas, which previously had been reported to contain more than 100 TIL per 20 high-powered fields. In a second study of 90 patients, we counted the number of immunohistochemically stained T lymphocytes per 20 high-powered fields in uveal melanomas from 30 patients who survived at least 15 years after enucleation, from 30 patients who died with metastasis within 2 years, and from 30 patients who died with metastasis more than 10 years after enucleation.
T cells predominated in 73.8% of the 80 patients, and B cells were more prevalent in 13.8%. T cells were usually scattered, and B cells were usually in clumps. Post-enucleation 18-yr mortality from metastasis was 73% for patients with either T- or B-cell predominance of their TIL. The mortality rate was 32% for patients with few TIL. The patients who survived at least 15 yrs after enucleation had fewer T lymphocytes infiltrating their uveal melanomas than the two groups of patients who died with metastasis.
The pattern of the TIL was different for T and B cells in uveal melanomas. T-lymphocytic infiltration is associated with death due to metastasis.
运用免疫组织化学方法研究葡萄膜黑色素瘤中肿瘤浸润淋巴细胞(TIL)与较高死亡率相关这一异常发现。
我们对80例葡萄膜恶性黑色素瘤进行了B淋巴细胞和T淋巴细胞的免疫组织化学检测,这些病例此前报道显示每20个高倍视野中TIL超过100个。在第二项针对90例患者的研究中,我们对30例眼球摘除术后至少存活15年的患者、30例术后2年内死于转移的患者以及30例术后10年以上死于转移的患者的葡萄膜黑色素瘤,计数每20个高倍视野中免疫组织化学染色的T淋巴细胞数量。
80例患者中73.8%以T细胞为主,13.8%以B细胞为主。T细胞通常呈散在分布,B细胞通常成簇。眼球摘除术后18年,TIL以T细胞或B细胞为主的患者因转移导致的死亡率为73%。TIL数量少的患者死亡率为32%。眼球摘除术后至少存活15年的患者,其葡萄膜黑色素瘤中浸润的T淋巴细胞比两组死于转移的患者少。
葡萄膜黑色素瘤中TIL的T细胞和B细胞模式不同。T淋巴细胞浸润与因转移导致的死亡相关。