CD8＋T细胞在胃癌组织中的表达及其临床意义

Expression and clinical significance of CD8＋ T cells in gastric carcinoma tissues

目的 观察胃癌组织中浸润性淋巴细胞CD8＋T的表达及临床作用.方法 应用免疫组织化学染色检测102例胃癌患者手术标本中浸润淋巴细胞CD8＋T的表达.结果 在胃癌、胃炎及胃息肉组织中均可见浸润淋巴细胞CD8＋T的表达,但胃癌组浸润淋巴细胞CD8＋T的表达[（29.53±14.71）个/HPF]明显高于慢性胃炎组[（19.54±8.10）个/HPF]和胃息肉组[（14.26±6.83）个/HPF],差异有统计学意义（P＜0.05）.CD8＋T细胞的表达与胃癌患者的性别、年龄、肿瘤部位、肿瘤大小、淋巴结转移、复发、病理分级和TNM分期无明显相关（P＞0.05）;但与组织学类型和浸润深度有关,其中分化型胃癌患者CD8＋T细胞的表达[（33.9±18.4）个/HPF]高于低分化型患者的表达[（27.6±12.0）个/HPF],差异有统计学意义（t=2.04,P＜0.05）;未侵入肌层组的CD8＋T细胞表达[（38.8±13.8）个/HPF]明显高于侵入肌层组[（27.7±14.1）个/HPF],差异有统计学意义（t=2.45,P＜0.05）.与CD8＋T细胞低表达组比较,CD8＋T细胞高表达组胃癌患者中位生存时间延长5个月,但差异无统计学意义（χ2=1.0274,P＞0.05）.多因素COX模型分析显示,与浸润淋巴细胞CD8＋T低表达组比较,高表达组有降低胃癌死亡风险的趋势（RR=0.82,95%CI=0.41～1.65）.结论 浸润性淋巴细胞CD8＋T的表达与胃癌的预后有关.

Objective To study the expression and clinical significance of infiltrating lymphocytes CD8 ＋ T in gastric carcinoma tissues.Methods The expression of infiltrating lymphocytes CD8 ＋ T in 102surgically resected specimens of gastric cancer tissues was detected by using immunohistochemistry.Results CD8＋ T cells were expressed both in gastric carcinoma,gastritis and gastric polyp tissues,but the number of CD8 ＋ T cells in gastric carcinoma tissues [（29.53 ± 14.71 ）/high powered field （HPF）]wassignificantly greater than in gastritis tissues [（ 19.54 ±8.10）/HPF]and polyp tissues [（ 14.26 ±6.83）/HPF]（P 〈0.05）.No correlation was found between CD8 ＋ T lymphocyte count and gender,age,tumor location,tumor size,lymph node metastasis,tumor relapse,pathological grade or TNM stage （ P 〉 0.05 ）.However,there was a statistically significant correlation between the number of CD8 ＋ T cells and the histological type,invasive depth.The CD8 ＋ T cell count was obviously higher in the differentiated group [（33.9 ± 18.4）/HPF]than in the undifferentiated group [（27.6 ± 12.0）/HPF]（ t = 2.04,P〈0.05 ）.And the number of CD8 ＋ T cells was greater in the non-invasive group [（38.8 ± 13.8）/HPF]than in the invasive group [（27.7 ± 14.1 ）/HPF]（ t = 2.45,P〈0.05 ）.The median survival time of gastric cancer patients with high expression of CD8 ＋ T cells was 5 months longer than in those with low expression,but there was no significant difference.Multi-factor COX model analysis demonstrated that the risk of death in gastric cancer patients was lower in the CD8 ＋ T cells high expression group than in the low expression group （ RR = 0.82,95%,CI = 0.41-1.65 ）.Conclusion Detection of infiltrating lymphocytes CD8 ＋ T expression in gastric carcinoma tissues will be beneficial to the judgment of the prognosis.