胃癌中肿瘤相关巨噬细胞的分布及其与患者预后的关系

Relationship of the distribution of tumor-associated macrophages and the prognosis of patients with gastric adenocarcinoma

目的探讨胃癌组织中肿瘤相关巨噬细胞(TAM)的分布及其与患者预后的关系。方法采用免疫组织化学法检测86例胃癌组织中TAM的表达,观察TAM在胃癌组织中的分布与患者术后生存的关系。结果胃腺癌组织及癌间质中均有大量的TAM浸润,且癌间质组织中TAM表达高于癌巢组织(P<0.01)。Ⅰ+Ⅱ期癌巢组织内TAM表达高于Ⅲ+Ⅳ期(P<0.05),但I+Ⅱ期癌间质组织中TAM表达低于Ⅲ+Ⅳ期(P<0.01);Ⅰ+Ⅱ期癌巢TAM/癌间质TAM的比值高于Ⅲ+Ⅳ期(P<0.05)。与癌巢TAM低表达者比较,癌巢TAM高表达者复发率低,5 a生存率高(P<0.05)。与癌间质TAM低表达者比较,癌间质TAM高表达者复发率高,5 a生存率低(P<0.05)。癌巢/癌间质TAM比值越大,复发率越低,5 a生存率越高(P<0.05)。结论癌巢组织TAM、癌间质组织TAM及癌巢/癌间质TAM比值可作为临床评估胃癌患者预后的指标。

Objective To investigate the relationship of the distribution of tumor-associated macrophages （TAM） and the prognosis of patients with gastric adenocarcinoma. Methods The expression of TAM in eighty-six gastric cancer tissues were detected by the immunohistochemical method, the relationship between the distribution of TAM and the postoperative prognosis was analyzed. Results A large number of TAM invasion were discovered in gastric ad tissues and cancer stroma,and the expression of TAM in cancer stroma was higher than that in cancer nest（P 〈0.01 ）. The expression of TAM in stage I ＋ II cancer nest was higher than that in stage III ＋ IV cancer nest （P 〈 0.05 ）, but the expression of TAM in stage I ＋ II cancer stroma was lower than that in III ＋ IV cancer stroma（P 〈 0.01 ）, and the ratio of cancer nest TAM/cancer stroma TAM of stage I ＋ II was higher than that of stage III ＋ IV （P 〈 0.05）. Compared with the patients with low expression of TAM in cancer nest,the relapse rate was lower,and the five year survival rate was higher in patients with higher expression of TAM in cancer nest （ P 〈 0.05 ）. Compared with the patients with low expression of TAM in cancer stroma, the relapse rate was higher, and the five year survival rate was lower in patients with higher expression of TAM in cancer stroma（P 〈 0.05 ）. With the increasing of the ratio of cancer nest TAM/cancer stroma TAM, the relapse rate degraded, the five year survival rate upgraded（P 〈 0.05 ）. Conclusion TAM in cancer nest,TAM in cancer stroma and their ratio can be used to estimate the prognosis of patients with gastric adenocarcinoma.