中国普外基础与临床杂志

中国普外基础与临床杂志

乳腺浸润性导管癌微环境中的 CD4+ T 细胞比例、CD8+ T 细胞比例及 P53 基因的表达

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目的 探索乳腺浸润性导管癌微环境中的 CD4+ T 细胞比例、CD8+ T 细胞比例及 P53 基因突变情况,并探讨其与乳腺浸润性导管癌预后的相关性。 方法 回顾性收集解放军第 371 中心医院于 2010–2012 年期间行手术切除的 85 例乳腺浸润性导管癌标本,采用免疫组织化学染色方法检测肿瘤组织中的 CD4+ T 细胞比例、CD8+ T 细胞比例、CD4+/CD8+ T 细胞比值及 P53 基因的突变情况。比较不同前哨淋巴结转移情况及不同 P53 基因突变情况患者肿瘤组织中上述指标的差异,并探索上述指标对乳腺浸润性导管癌患者预后的影响。 结果 ① CD4+ T 细胞比例、CD8+ T 细胞比例及 CD4+/CD8+ T 细胞比值与前哨淋巴结转移的关系:在肿瘤簇中,与前哨淋巴结转移组患者比较,前哨淋巴结未转移组患者的 CD4+ T 细胞比例及 CD4+/CD8+ T 细胞比值的差异均无统计学意义(P>0.05),但前哨淋巴结未转移组患者的 CD8+ T 细胞比例较低(P<0.05);在肿瘤间质中,与前哨淋巴结转移组患者比较,前哨淋巴结未转移组患者的 CD4+ T 细胞比例和 CD8+ T 细胞比例均较低(P<0.05),CD4+/CD8+ T 细胞比值较高(P<0.05)。② CD4+ T 细胞比例、CD8+ T 细胞比例及 CD4+/CD8+ T 细胞比值与 P53 基因突变的关系:不管是在肿瘤簇中还是在间质内,与 P53 基因突变组患者比较,P53 基因未突变组患者的 CD4+ T 细胞比例及 CD8+ T 细胞比例均较低(P<0.05),而 CD4+/CD8+ T 细胞比值均较高(P<0.05)。③ CD8+ T 细胞浸润程度和 P53 基因表达与预后的关系:CD8+ T 细胞高浸润者的预后较低浸润者差(P<0.05),P53 基因突变者的预后较未突变者差(P<0.05)。 结论 CD4+ T 细胞比例、CD8+ T 细胞比例、CD4+/CD8+ T 细胞比值与前哨淋巴结转移及 P53 基因突变有相关性,且 CD8+ T 细胞比例与 P53 基因突变与乳腺浸润性导管癌的预后有关。

Objective To investigate the proportions of CD4+ T cells, CD8+ T cells, and mutant of P53 gene in the microenvironment of breast infiltrating ductal carcinoma, and to explore its’ correlation with prognosis of breast infiltrating ductal carcinoma. Methods Eighty-five cases of breast infiltrating ductal carcinoma were collected who underwent surgery in The 371st Central Hospital of PLA from 2010 to 2012, and then detected the proportion of CD4+ T cells and CD8+ T cells, ratio of CD4+ T cells to CD8+ T cells, and mutant of P53 gene in the cancer tissue with immunohistochemistry. Comparison between the sentinel lymph node metastasis group and non-sentinel lymph node metastasis group, mutant of P53 gene group and non-mutant of P53 gene group on the proportions of CD4+ T cells, CD8+ T cells, and ratio of CD4+ T cells to CD8+ T cells was performed, as well as the relationship between proportion of CD8+ T cells/mutant of P53 gene and prognosis of breast infiltrating ductal carcinoma. Results ① The relationship between proportion of CD4+ T cells/proportion of CD8+ T cells/ratio of CD4+ T cells to CD8+ T cells and situation of sentinel lymph node metastasis: at cluster, compared with sentinel lymph node metastasis group, the proportion of CD8+ T cells was lower in non-sentinel lymph node metastasis group (P<0.05), but there was no significant difference on the proportion of CD4+ T cells and ratio of CD4+ T cells to CD8+ T cells (P>0.05); at stroma, compared with sentinel lymph node metastasis group, the proportions of CD4+ T cells and CD8+ T cells were lower, but the ratio of CD4+ T cells to CD8+ T cells was higher in non-sentinel lymph node metastasis group (P<0.05). ② The relationship between proportion of CD4+ T cells/proportion of CD8+ T cells/ratio of CD4+ T cells to CD8+ T cells and mutant of P53 gene: both at the cluster and stroma, compared with mutant of P53 gene group, the proportions of CD4+ T cells and CD8+ T cells were lower, but the ratio of CD4+ T cells to CD8+ T cells was higher in non-mutant of P53 gene group (P<0.05). ③ The relationship between proportion of CD8+ T cells/mutant of P53 gene and prognosis of breast infiltrating ductal carcinoma: the prognosis was worse in patients with high degree of infiltration of CD8+ T cells and mutant of P53 gene than those patients with low degree of infiltration of CD8+ T cells and non-mutant of P53 gene (P<0.05). Conclusion The proportions of CD4+ T cells and CD8+ T cells, and ratio of CD4+ T cells to CD8+ T cells are associated with the situation of sentinel lymph node metastasis and mutant of P53 gene, and the degree of infiltration of CD8+ T cells and mutant of P53 gene are associated with the prognosis of breast infiltrating ductal carcinoma.

关键词: 乳腺浸润性导管癌; CD4+T 细胞; CD8+T 细胞; 前哨淋巴结; P53 基因; 预后

Key words: breast infiltrating ductal carcinoma; CD4+ T cells; CD8+ T cells; sentinel lymph node metastasis; P53 gene; prognosis

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