胆囊癌中吲哚胺2，3-双加氧酶的表达和调节性T细胞的浸润及其临床意义

Expression of indoleamine 2,3-dioxygenase and regulatory T cells infiltration in gallbladder carcinoma and clinical significance

目的探讨在胆囊癌（GC）中吲哚胺2，3-双加氧酶（IDO）表达和调节性T细胞（Tregs）的浸润及其与临床预后的关系。方法应用免疫组织化学技术EnVision法检测52例胆囊癌组织中IDO及Tregs的特异性标志物叉头状／翅翼状螺旋转录因子（FoxP3）的表达，15例慢性结石性胆囊炎组织进行对照，分析IDO、FoxP3的表达与临床病理特征及预后的关系。结果胆囊癌组织IDO强表达者（＋＋～＋＋＋）19例（36．5％），缺失或弱表达者（-～＋）33例（63．5％），Tregs的数量为（2．3±2．1）／HP，慢性胆囊炎标本中未见IDO及FoxP3表达；胆囊癌组织IDO与Tregs之间呈线性相关（r=0．619，P〈0．05）；胆囊癌组织中IDO表达强度、Tregs数量与UICC分期、癌细胞分化程度相关（P〈0．05）；肿瘤组织中IDO表达强度、Tregs数量、UICC分期是影响胆囊癌根治术后5年总生存率的独立危险因素（P〈0．05）。结论IDO的表达强度、局部浸润Tregs的数量与肿瘤的分级、分期相关；IDO的表达强度与Tregs的数量是影响胆囊癌根治术后5年总生存率的独立危险因素。

Objective To investigate the expression of indoleamine 2,3-dioxygenase （IDO） and regulatory T cells （ Tregs ） infiltration in gallbladder carcinoma （ GC ） and their correlation with clinical prognosis. Methods Immunohistochemistry was used to detect the expression of IDO and FoxP3 in the tissue samples of 52 GC cases, and 15 cases of chronic calculous cholecystitis as controls. The correlation between the expression of IDO and FoxP3 with clinicopathological features and prognosis was analyzed. Resuits Strong expression of IDO （＋＋～＋＋＋ ） was detected in 19 GC cases （ 36. 5% ） and lack of or weak expression of IDO （ -～＋ ） occurred in 33 GC cases （63.5%）. IDO and FoxP3 staining was not seen in tissue samples of chronic calculous cholecystitis. The expression of IDO was significantly correlated with the number of Tregs in the tissue of GC （r =0. 619,P 〈0. 05） , and IDO and Tregs were significantly correlated with UICC stage and cancer cell differentiation （ P 〈 0. 05）. Multivariate COX analysis revealed that IDO high expression, Tregs infiltration in tumor tissues and UICC stage emerged as independent prognosis variables for 5-year overall survival rate in GC patients. Conclusion The expression of IDO and Tregs infiltration in tissues of GC are related to tumor grade and stage. IDO expression and Tregs inflitration in tumors significantly contribute to disease progression and overall survival in patients whith GC.