喉癌癌周浸润细胞的表现型和临床预后的关系

The Relationship Between the Phenotype of Tumor Infiltrating Cells and the Prognosis in Laryngeal Cancer

应用免疫组化ＡＢＣ法及甲苯胺兰和ＨＥ染色对８２例喉癌切除标本癌周浸润的Ｔ淋巴细胞，Ｂ淋巴细胞，巨噬细胞，郎格罕细胞，肥大细胞和嗜酸性粒细胞的浸润程度、分布特点进行了观察。同时结合临床随访对与临床预后有影响的八个临床、病理学指标及六类浸润细胞进行多因素逐步Ｌｏｇｉｓｔｉｃ回归分析。结果发现喉癌局部有不同程度的上述细胞浸润。除Ｂ淋巴细胞以外各类细胞的浸润程度对临床预后（５年存活率）均有一定影响（Ｐ＜０．０１）。通过多因素分析认为嗜酸性粒细胞的浸润程度是影响预后的最重要因素（Ｐ＝０．００３），其次为Ｔ淋巴细胞（Ｐ＝０．００５）和肿瘤组织学分级（Ｐ＝０．０３３）。说明癌周浸润细胞在宿主局部抗肿瘤免疫反应中起重要作用。

By using the method of immunohistochemical avidin-biotin-peroxdase complx(ABC),toluidine blue and HE staining,the infiltrated grade and dispersed feature about the T-lymphocytes,B-Lymphocytes,macrophages, langerhans cells, mast cells and eosinophels of peritumoral stroma were investigated in 82 cases with laryngeal carcinoma.A stepwise logistic regression analysis of eight clinico-pathologic variables and the density of six kinds of tumor infiltrating cells in the study were analyzed with the clinical outcome of the patients, The results showed that T-lymphocytes was the mojor infil-trated cells.The other cells such as macrophages,langerhans cells,mast cells and eosinophils were also to be found in local infiltration,but the B-cell was scanty.All these cells except B-cell had significant ef-fect on the 5-year surviral rate of the patients.By the multivariate analysis,the peritumoral infiltrated eosinophils was the most influential variable affecting clinical outcome,followed by the peritumoual infil-trated T-lymphocytes and the tumor histologic grade.We concluded that tumor infiltrating cells played a critical role in local host antitumor immune reaction.