肿瘤相关巨噬细胞和调节性T细胞在胃间质瘤中的浸润及意义

Invasion of tumor associated macrophage and regulatory T cells in gastric stromal tumor and its clinical significance

目的探讨肿瘤相关巨噬细胞(TAM)及CD4+CD25+Foxp3+调节性T细胞(Tregs)在胃间质瘤中的浸润及临床意义。方法回顾性分析64例胃间质瘤患者的临床病例资料并进行随访,分为:极低危组、低危组(合并为A组);中危组、高危组(合并为B组)。采用免疫组织化学方法检测CD68、Foxp3蛋白在胃间质瘤组织中的表达水平,分析TAM、Tregs细胞在胃间质瘤中的浸润与肿瘤危险度分级及预后的关系。结果 CD68蛋白在B组的表达率为81.5%,A组表达率为54.1%,差异有统计学意义(P<0.05),Foxp3蛋白在B组的表达率为88.9%,A组表达率为51.4%,差异有统计学意义(P<0.05)。Kaplan-Meier生存曲线显示CD68、Foxp3蛋白阳性组的患者生存率低于阴性组,差异有统计学意义(P<0.05)。二者在胃间质瘤中的浸润与肿瘤分级有关(P<0.05),与性别、年龄、肿瘤部位无关。结论TAM及Tregs在胃间质瘤中浸润可能促进肿瘤的浸润和发展,并和预后不良相关。

Objective To evaluate the invasion of tumor associated macrophage （TAM） and regulatory T cells （Tregs） in gastric stromal tumors（GST） and its clinical significance. Methods 64 cases of GST were retrospec- tively analyzed by reviewing medical literatuer, these cases were divided into two groups by tumor risk classifica- tion, very low and low group （A group） and intermediate and high group （B group ）. The proteins of CD68 and Foxp3 in 64 cases of GST were detected with immunohistochemical staining, and the relationship between the tow cells and clinicopathological features or prognosis of GST were analyzed. Results Proteins expression of CD68 and Foxp3 in intermidiate and high group were 81.5% and 88.9% , having statistical significance with （ P 〈 0. 05 ） 54. 1% and 51.4% in low and very low group. Kaplan-Meier analysis suggested that infiltrated TAM and Tregs were associated with poor prognosis. There was no significant correlation between the expression of CD68 or Foxp3 protein with age, gender, tumor location in patients with GST（ P 〉 0.05 ）. However, there was significant correlation between the expression of CD68 or Foxp3 protein with tumor stage （P 〈 0. 05 ）. Conclusion TAM and Tregs in GST invasion and infiltration may promote tumor progression, and are associated with poor prognosis.