乳腺浸润性导管癌中肿瘤相关巨噬细胞与淋巴管生成的关系

Relationship between tumor-associated macrophages and lymphangiongenesis in the breast invasive ductal carcinoma

目的:检测乳腺浸润性导管癌中的肿瘤相关巨噬细胞(tumor-associated macrophages,TAMs)浸润及淋巴管生成情况,探讨肿瘤组织中TAMs与乳腺浸润性导管癌临床病理指标及肿瘤淋巴管生成的关系。方法:收集遂宁市中心医院外科手术切除的乳腺浸润性导管癌标本共53例。其中年龄>55岁者23例,年龄≤55岁者30例;肿瘤最大直径≤4 cm者26例,肿瘤最大直径>4 cm者27例;有淋巴结转移者39例,无淋巴结转移者14例;组织学分级为中高分化者36例,低分化者17例。应用免疫组织化学方法检测乳腺浸润性导管癌组织中TAMs的浸润情况和淋巴管密度,分析CD68阳性的TAMs和淋巴管密度与乳腺浸润性导管癌临床病理指标的联系及它们之间的相关性。结果:乳腺浸润性导管癌中CD68阳性的TAMs散在分布于癌巢及周围间质中,以癌周间质为主,其计数明显高于周围正常组织(P<0.05)。肿瘤组织的淋巴管主要分布在癌巢周围间质内,形态不规则,且淋巴管密度明显高于周围正常组织(P<0.05)。淋巴结转移者CD68阳性的TAMs和淋巴管密度均高于无淋巴结转移者(均P<0.05)。但与患者年龄、肿瘤的最大直径及肿瘤的分化程度等均无统计学意义(均P>0.05)。此外,肿瘤组织中CD68阳性的TAMs与淋巴管密度有显著的相关性(r=0.457,P<0.01)。结论:CD68阳性的TAMs在乳腺浸润性导管癌间质中广泛浸润,并与肿瘤周围间质中淋巴管密度呈正相关。

Objective： To examine the tumor-associated macrophages （TAMs） infiltration and lymphangiongenesis, and further to study the relationships between TAMs in the tumor tissue and the clinical pathological indicators and lymphangiongenesis in the breast invasive ductal carcinoma. Methods： Specimens of 53 patients with breast invasive ductal carcinoma were collected in the Suining Central Hospital, including 23 patients whose age were above 55, and 30 below 55 （included）; 26 patients whose maximum diameter of tumor were less or equivalent to 4 cm, and 27 more than 4 cm; 39 patients had lymph node metastasis, and 14 had not lymph node metastasis; and 36 patients＇ histological grades were middle or high differentiation, and 17 low differentiation. The TAMs infiltration and lymphatic vessel density （LVD） were examined in the breast invasive ductal carcinoma tissues by immunohistochemistry and analyzed the relationship among TAMs, LVD and the clinical pathological indicators in the breast invasive ductal carcinoma as well as the correlations between TAMs and LVD. Results： The CD68-positive TAMs in the breast invasive ductal carcinoma were scattered in the cancer nest and surrounding mesenchymes, mainly in the latter ones with quantity apparently higher than that in the surrounding normal tissues （P〈0.05）. The lymphatic vessels of the tumor tissues were mainly distributed in the mesenchymes around the cancer nest with irregular shape, and the LVD value was obviously higher than that in the surrounding normal tissues （P〈0.05）. The patients with lymphatic metastasis had higher CD68-positive TAMs and LVD than those without lymphatic metastasis （P〈0.05）. However, there was no significant differences in the age of the patients, max diameter of the tumor and the differentiation degree of the tumor （all P 〉 0.05）. Furthermore, there was correlation between the TAMs in the tumor tissues and the LVD （r=0.457, P〈0.01）. Conclusion： ＂The CD68- positive TAMs extensively infiltrate into the mesenchymes of the breast invasive ductal carcinoma, and which are correlated with the LVD.