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,并探讨它们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 细胞比值以及 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 细胞比例及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 基因突变及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 Peoples’ Liberation Army 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 tissues 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 were 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 the sentinel lymph node metastasis group, the proportion of CD8+ T cells was lower in the 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 the 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 the 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 the 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 the 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). Conclusions 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 cell; CD8+ T cell; sentinel lymph node metastasis; p53 gene; prognosis

引用本文: 许晶晶, 刘峰, 杨廷桐, 陆建福. 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 . 中国普外基础与临床杂志, 2018, 25(3): 328-333. doi: 10.7507/1007-9424.201709032 复制

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