肿瘤浸润淋巴细胞在食管癌组织中表达及与预后的关系

The expression of tumor-infiltrating lymphocytes and its relationship with prognosis of esophageal carcinoma

目的:研究食管癌组织中浸润的CD3+T、CD8+T、颗粒酶B(granzyme B,GrB)阳性T细胞和Foxp3+调节性T细胞(regulatory Tcell,Treg)表达情况及对预后的影响。方法:应用免疫组织化学法检测CD3、CD8、GrB和Foxp3在90例食管癌间质和癌巢中的表达,计数阳性细胞,应用Cox回归模型和Kaplan-Meier生存曲线分析其与患者预后的关系。结果:本组病例3年总生存率为66.67%(60/90)。单因素生存分析表明,食管癌间质和癌巢中CD3+T、CD8+T细胞高表达组3年生存率高于低表达组,差异有统计学意义(P<0.05);GrB+T细胞高表达组较低表达组有生存优势,但差异无统计学意义(P>0.05);Foxp3+Treg细胞高表达组生存率低于低表达组,差异有统计学意义(P<0.05)。Cox模型多因素分析表明,食管癌间质浸润的CD3+T、CD8+T、Foxp3+Treg细胞数量、病变长度和TNM分期均是影响生存期的独立因素(均P<0.05)。结论:间质浸润的CD3+T、CD8+T细胞增多时患者预后良好,Foxp3+Treg细胞数量增多则预后不良。

Objective：To investigate the expression and prognostic value of tumor-infiltrating lymphoeytes （TILs）, including CD3 ＋ T cells, CD8 ＋ T cells, granzyme B （GrB） ＋ T cells, and Foxp3 ＋ regulatory T（Treg） cells in esophageal carcinoma. Methods： The expressions of CD3,CD8, GrB, and Foxp3 in the stroma and cancer cell nest were detected by SP immunohistochemistry method in 90 specimens of esophageal cancer. The number of positive cells was counted. Their relationships with prognosis of patients were evaluated by Cox regression model and Kaplan-Meier survival curve analysis. Results：The three-year overall survival rate of the patients was 66.67 % （60/90）. Univariate survival analysis suggested that three-year survival rate of the patients with over-expression of CD3 ＋ T and CD8＋ T cells in stroma and cancer nest was higher than that in those patients with weak expression of CD3 ＋ T and CD8＋ T cells. The difference was significant （ P 〈 0.05 ）. The patients with overexpression of GrB ＋ T cells had higher surival rate compared with those with weak expression of GrB ＋ T cells. There was no significant difference between them （ P 〉 0.05 ）. The patients with overexpression of Foxp3 ＋Treg cells had lower survival rate than those with weak expression of Foxp3 ＋ Treg cells. The difference was significant （ P 〈 0.05）. Cox multivariate analysis indicated that the number of CD3 ＋ T, CD8＋ T , and Foxp3 ＋ Treg cells in stroma, the length of lesions, and TNM staging were the independent prognostic factors affecting survival rate of patients （P 〈 0.05 ）. Conclusion： The increase in the number of CD3 ＋ T and CD8＋ T cells in the stroma predicts well prognosis. The increased number of Foxp3＋ Treg cells may be related with poor prognosis.