摘要
目的研究肿瘤浸润T淋巴细胞在乳腺癌原发灶中的表达及其与预后的关系。方法回顾性收集乳腺癌患者105例临床资料、病理资料和石蜡包埋病理标本,采用免疫组化检测CD3+T淋巴细胞、CD4+T淋巴细胞、CD8+T淋巴细胞在乳腺癌原发灶的表达,采用COX单因素和多因素分析无病生存率(DFS)和总生存率(OS)相关因素。结果 105例患者乳腺癌原发灶CD3+阳性101例(96.19%),CD4+阳性55例(52.38%),CD8+阳性71例(67.62%),CD3+T淋巴细胞浸润与年龄、肿瘤直径、临床分期、SBR分级、ER表达、PR表达、HER-2表达、淋巴结状态无关,CD4+T淋巴细胞浸润与SBR分级、HER-2表达有关(P<0.05),CD8+T淋巴细胞浸润与SBR分级有关(P<0.05)。单因素分析显示,临床分期、SBR分级、HER-2阳性、淋巴结转移、CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润与DFS有关(P<0.05);临床分期、SBR分级、HER-2阳性、淋巴结转移、CD4+浸润、CD8+浸润与OS有关(P<0.05);多因素分析显示,CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润是DFS的保护因素(HR=0.655、0.534,P<0.05);CD4+T淋巴细胞浸润、CD8+T淋巴细胞浸润是OS的保护因素(HR=0.525、0.628,P<0.05)。结论乳腺癌原发灶普遍存在CD3+T淋巴细胞浸润,CD4+T淋巴细胞、CD8+T淋巴细胞浸润与病变程度有关,两者均与乳腺癌较好预后有关。
Objective To research tumor-infiltrating T lymphocytes in breast primary tumor expression and the relationship with prognosis. Methods Retrospectively collected clinical data of 105 cases of breast cancer patients, pathological data and paraffin-embedded pathological specimens, using immunohistochemical detection of CD3+T cells, CD4^+T cells, CD8^+T cells in primary tumors in breast cancer, used univariate and multivariate COX factor analysis of diseasefree survival(DFS), overall survival(OS) related factors. Results The primary tumor CD3+positive 101 cases(96.19%),in 105 cases with breast cancer CD4^+positive 55 cases(52.38%), CD8^+positive 71 cases(67.62%), CD3+T cells infiltration with age, tumor size, clinical stage, differentiation degree, SBR grade, ER expression, PR expression, HER-2expression and lymph node status were independent, CD4^+T cells infiltration were related to SBR grade, HER-2(P〈0.05), CD8^+T cells infiltration were related to cell differentiation and SBR grade(P〈0.05). Univariate analysis showed that clinical stage, degree of differentiation, SBR grade, HER-2 positive, lymph node metastasis, CD4^+T cells infiltration, CD8^+T cells infiltration were related to DFS(P〈0.05); clinical stage, SBR grade, HER-2-positive, lymph node transfer, CD4^+T cells infiltration, CD8^+infiltration were related to OS(P〈0.05); multivariate analysis shows, CD4^+T cells infiltration, CD8^+T cells infiltration were protective factor for DFS(HR=0.655, 0.534, P〈0.05); CD4^+T cells infiltration,CD8^+T cells infiltration were protective factor for OS(HR=0.525,0.628, P〈0.05). Conclusion The prevalence of breast cancer primary tumor infil tration of CD3+T cells, CD4^+T cells, CD8^+T cells infiltration and related lesions, both with better prognosis in breast cancer.
出处
《中国现代医生》
2015年第6期13-16,23,共5页
China Modern Doctor
基金
国家医学教育发展中心课题项目(2012-03-07-143)