保乳术中癌及切缘组织中IDO的表达与T细胞和MVD表达的临床意义

Clinical significance of IDO expression,Regulatory T cells and MVD in breast conserving surgery

目的探讨保乳术中癌组织、切缘组织中吲哚胺2,3-双加氧酶(IDO)的表达与调节性T细胞(Tregs)、新生血管微血管密度(MVD)表达的关系及与患者预后的关系。方法选取2008年至2011年收集的63例保乳术患者癌组织、切缘组织60例及正常乳腺组织标本30例,采用免疫组织化学法检测三组标本中IDO、Tregs、CD105标记的MVD(MVD-CD105)表达情况,数据分析在SAS 9.3软件包中处理,乳腺组织中IDO、MVD-CD105、Tregs阳性着色指数采用均数±标准差(x珋±s)表示,采用方差分析;IDO、MVD-CD105、Tregs阳性表达率、生存率比较采用卡方检验;相关性分析采用Pearson分析法;P<0.05表示差异具有统计学意义。结果乳腺癌组织中IDO、MVD-CD105、Tregs阳性表达率均显著的高于切缘组织和正常乳腺组织(P<0.05)。乳腺癌组织中的IDO阳性着色指数与MVD-CD105、Tregs阳性着色指数呈显著的正相关关系(P<0.05)。乳腺癌组织中IDO阳性表达患者的5年总生存率71.11%显著的低于阴性患者的94.44%,差异有统计学意义(χ~2=4.050,P<0.05)。结论乳腺癌组织中IDO表达水平显著的增高,并且与MVD形成有关,与患者的预后不良有一定的关系。

Objective To investigate the expression of 2,3- （ IDO）, microvessel density （MVD） and regulatory T cells （Tregs） in breast cancer and surgical margins, to discuss their relationships with the prognosis of patients. Methods From 2008 to 2011, 63 patients, who received breast-conserving surgery, were enrolled. Tumor and surgical margin specimens of 60 cases were harvested, while normal breast tissue specimens of 30 cases were harvested. The expression of IDO, MVD （ CD105 ） and Tregs were detected by using immunohistochemistry staining Data analysis were performed by using SAS 9. 3 software package. Measurement data were expressed as mean ±standard deviation （x±s） , and were examined by using variance analysis, including postive staining index of IDO, MVD （CD105） and Tregs. Count data, such as postive staining rate of IDO, MVD （CD105） and Tregs, were examined by using X2 test and Pearson correlation analysis. A P value 〈 0. 05 was considered as statistically significant difference. Results Positive expression rates of IDO, MVD-CD105 and Tregs in breast cancer were significantly higher than those in both surgical margins and normal breast tissue respectively （ P 〈 0.05 ）. There was a positive correlation between IDO expression and the positive staining of Tregs and MVD-CD105 in breast cancer （P 〈 0.05）. 5 years survival rate of 71.11% in patients with positive IDO expression in breast cancer was significantly lower than 94. 44% in patients with negative IDO expression, with significant difference （χ2 = 4. 050, P 〈 0.05 ）. Conclusion IDO expression is upregulated in breast cancer, which might be associated with MVD formation and poor prognosis.