桥本甲状腺炎合并甲状腺癌患者肿瘤内抗肿瘤免疫临床意义

The Clinical Significance of Anti-Tumor Immunity in Tumor Tissues of Patients with Hashimoto's Thyroiditis with Thyroid Papillary Carcinoma

目的观察桥本甲状腺炎合并甲状腺癌患者肿瘤内抗肿瘤免疫并探讨其临床意义。方法应用免疫组织化学二步法检测桥本甲状腺炎合并甲状腺乳头状癌患者肿瘤组织内S-100蛋白呈阳性的树突状细胞及HLA-DR抗原呈阳性表达的细胞并探讨其临床意义。结果桥本甲状腺炎合并甲状腺乳头状癌患者肿瘤组织内存在大量树突状细胞(8/8),数量明显多于不伴桥本甲状腺炎的甲状腺癌患者(1/20),树突状细胞的胞浆突起插入癌细胞之间并与之接触。癌细胞呈不同程度HLA-DR抗原阳性表达。在树突状细胞及HLA-DR抗原阳性表达的癌细胞间可见大量淋巴细胞围绕。癌细胞存在不同程度坏死、崩解、脱落。结论桥本甲状腺炎合并甲状腺乳头状癌患者肿瘤组织内存在由树突状细胞、淋巴细胞及HLA-DR抗原阳性表达的癌细胞引起的特异性抗肿瘤免疫,与患者预后可能密切相关。

Objective To observe the anti-tumor immunity in tumor tissues of patients with Hashimoto＇ s （HT） with thyroid papillary carcinoma and to explore clinic significance. Methods S-100 protein positive dendritic cells（DC） and HLA-DR antigen positive expression carcinoma cells in tumor tissues of patients with HT with thyroid papillary carcinoma were studied by immunohistochcmical method. Results In HT with thyroid papillary carcinoma, there were a great number of DC in tumor tissues and the number were much more than those of thyroid carcinoma without HT, Dendritic projections of DC intervened between carcinoma cells and came into contact with them. The carcinoma cells showed varying degree of DR antigen positive expressions. DC and DR antigen positive expression carcinoma cells were around by a great number of lymphocytcs. Necrosis of carcinoma cells could be found. Conclusions There were anti-tumor immunity caused by the infiltration of DC, DR antigen positive expression carcinoma cells and infiltrating lymphocytcs in tumor tissues of patients with HT thyroid papillary carcinoma and may be closely related to postoperative prognosis.