肿瘤相关巨噬细胞在乳腺浸润性微乳头状癌中的浸润及意义

Significance of tumor-associated macrophages in invasive micropapillary carcinoma of breast

目的 研究肿瘤相关巨噬细胞（tumor associated macrophages,TAMs）在乳腺浸润性微乳头状癌（invasive micropapillary carcinoma,IMPC）中的浸润及意义.方法 采用免疫组织化学链霉亲和素生物素法（laballad streptavidin biotin method,LSAB）检测68例IMPC和72例浸润性导管癌非特殊型（invasive ductal carcinoma,not otherwise specified,IDC-NOS）中TAMs标记物CD68、CD163的表达,并探讨其与临床病理学特征的关系.结果 CD68、CD163主要表达于IMPC及IDC-NOS间质中浸润的巨噬细胞的胞膜或胞质内,癌巢内偶有表达.IMPC组瘤内间质CD68的表达率（47/68,69.1％）明显高于IDC-NOS组（37/72,51.5％）,差异具有统计学意义（P =0.022）.而瘤内间质CD163在2组间的表达无统计学意义（P =0.682）.IMPC中瘤内间质CD68的表达与病理学分期、组织学分级、淋巴结转移、脉管侵犯及Ki67的表达呈正相关（P＜0.05）,而与ER的表达呈负相关（P =0.037）.Kaplan-Meier单因素生存曲线分析显示,IMPC中瘤内间质CD68表达与无进展生存期（progression free survival,PFS）呈负相关（P =0.027）.结论 IMPC间质中CD68标记的TAMs可能在IMPC高侵袭、高转移的恶性生物学行为中发挥了重要的作用.

Objective To investigate the expression and clinical significance of tumor-associated macrophages （TAMs） in invasive micropapillary carcinoma （IMPC） of breast.Methods Immunohistochemical streptavidin-biotin method（LSAB） method for CD68 and CD163 were performed on 68 cases of IMPC and 72 cases of invasive ductal carcinoma,not otherwise specified（IDC-NOS）.Results CD68 and CD163 were mainly expressed in IMPC interstitial macrophages in the cytoplasm or on the membrane,and occasionally expressed in tumor nest.CD68 positive rate in tumor stroma in IMPC （47/68,69.1％） was higher than in IDC-NOS group （37/72,51.5％）,and the difference between the two groups was statistically significant （P =0.022）.CD163 positive rate in tumor stroma between the two groups was not statistically significant（P =0.682）.CD68 ＋ macrophages in IMPC stroma were positively correlated with pathological stage,histological grade,lymph node metastasis,vascular invasion,and Ki67 expression（P ＜ 0.05）,and inversely correlated with the expression of ER（P =0.037）.Univariate analysis showed that CD68 ＋ macrophages in the stroma of IMPC were significantly associated with progression-free survival（P =0.027）,Conclusion The expression of TAMs was different in different types of breast carcinoma and widely expressed in IMPC,which may play a significant role in high invasion and metastasis behavior of IMPC.