TAM与VEGF在外周T细胞淋巴瘤非特指型中表达及临床意义

Expression and Clinical Significance of Tumor-associated Macrophages and VEGF in Peripheral T-cell Lymphoma Not Otherwise Specified

目的:探讨肿瘤相关巨噬细胞(TAM)及血管内皮生长因子(VECF)在外周T细胞淋巴瘤非特指型(PTCL-NOS)中的表达及临床意义。方法:采用免疫组织化学方法对60例PTCL-NOS患者肿瘤组织中的CD68和VEGF进行检测,15例正常人淋巴结组织为对照。结果:肿瘤组织中CD68阳性细胞平均含量为(56.5±18.6)个/高倍镜视野,而对照组为(12.4±6.2)个/高倍镜视野(P<0.01),肿瘤组织与对照组VEGF阳性表达率分别为78.3%和26.7%(P<0.05)。TAM与骨髓侵犯、IPI评分及疗效相关(P<0.05)。TAM高表达组和低表达组的2年总生存率(overall survival,OS)分别为23.6%和55.3%(P<0.05)。VEGF的表达与肿瘤分期、骨髓侵犯和IPI评分相关(P<0.05),VEGF表达阳性组和阴性组的2年OS分别为22.9%和83.3%(P<0.01)。单变量生存分析显示VEGF表达、TAM计数、肿瘤分期、IPI评分和疗效是独立的预后影响因素(P<0.05)。多变量分析显示VEGF和疗效是独立的预后影响因素(P<0.05)。结论:TAM和VEGF在PTCL-NOS中表达明显升高,单因素分析显示二者是PTCL-NOS的不良预后因素。多因素分析显示仅VEGF是独立的预后影响因素。

Objective： This work aims to detect the expression and to identify the clinical significance of tumor-associated macro- phages （TAMs） and vascular endothelial growth factor （VEGF） in peripheral T-cell lymphoma not otherwise specified （PTCL-NOS）. Methods： Immunohistochemistry was used to detect CD68 and VEGF expressions in the tumor specimens of 60 cases with PT- CL-NOS. A normal lymph node biopsy was used as the control sample. Results： The average content of the CD68-positive cells was 56.5± 18.6 per high-power field （HPF） in the PTCL-NOS tissues and 12.4±6.2 per HPF in the control sample （P〈0.01）. The VEGF-posi- tive rates for the PTCL-NOS tissues and the control sample were 78.3% and 26.7% （P〈0.05）, respectively. TAMs were significantly cor- related to bone marrow invasion, IPI score, and treatment response （P〈0.05）. The two-year overall survival （OS） was 23.6% and 55.3% in the groups with high-TAM- and low-TAM-expression, respectively （P〈0.05）. VEGF expression was closely correlated to tumor stag- ing, bone marrow invasion, and IPI score （P〈0.05）. The two-year OS was 22.9% and 83.3% in the VEGF-positive and VEGF-negative groups, respectively （P〈0.01）. A univariate survival analysis revealed that the VEGF expression, TAMs content, rumor staging, IPI score, and treatment response were the prognostic factors of patients with PTCL-NOS （/9〈0.05）. A multivariate Cox regression model showed that VEGF and treatment response were both independent OS predictors （P〈0.05）. Conclusion： TAMs and VEGF are overex- pressed in PTCL-NOS. A univariate survival analysis reveals that TAMs and VEGF are both predictive factors for PTCL-NOS prognosis, and the multivariate survival analysis using Cox regression model data show that only VEGF is an independent predictive factor for OS.