肿瘤相关CD66b阳性中性粒细胞对预测宫颈癌Ⅰb至Ⅱa期复发的价值

Value of tumor-associated CD66b-positive neutrophils for the prediction of the recurrence of stage Ⅰb and Ⅱa cervical cancer

目的:探讨宫颈癌组织中的多形核嗜中性粒细胞(polymorphnuclear neutrophil,PMN)数量在预测宫颈癌复发中的作用。方法:回顾性分析1999年2月至2006年12月湖北省妇幼保健院及武汉大学中南医院92例初治宫颈癌Ⅰb~Ⅱa期患者的临床病理资料。采用免疫组织化学法检测宫颈癌组织中CD66b阳性的PMN数量,计算PMN数量平均值。将患者按宫颈癌组织中PMN浸润数量分组,数量>PMN平均值为A组,数量≤PMN平均值为B组。以无复发生存(recurrence free survival,RFS)为结点,采用Kaplan-Meier法进行单因素分析,采用Cox风险回归模型进行多因素分析。结果:A组的RFS期明显短于B组(P=0.001)。单因素及Cox风险回归模型多因素分析结果显示,腺癌(HR为3.020,95%CI为1.340~6.805,P=0.008)、淋巴结转移(HR为2.450,95%CI为1.065~5.637,P=0.035)、PMN浸润数量增加(HR为2.866,95%CI为1.274~46.447,P=0.011)为宫颈癌患者RFS的独立危险因素。结论:宫颈癌组织中PMN数量的增加与宫颈癌患者RFS期缩短相关,是宫颈癌患者预后不良的一个潜在预测指标。

Objective： To investigate the prognostic effect of polymorphnuclear neutrophil（PMN） in cervical cancer. Methods： Patients（n=92） who underwent curative surgery for the treatment of stage Ib and IIa cervical cancer according to the International Federation of Gynecology and Obstetrics（FIGO） were assessed to determine their tumor-infiltrating CD66 b-positive neutrophils through immunohistochemistry. Assessment results were then analyzed to identify their correlation with recurrence-free survival（RFS） as an end point.Kaplan–Meier method was used for survival curve analysis, and a Cox proportional hazard model was utilized for univariate and multivariate analyses. Results： The RFS of the group with a density of CD66 b-positive neutrophils above the median in cervical cancer tissues was significantly shorter than that of the group with a density of CD66 b-positive neutrophils below the median（P=0.001）. Univariate and multivariate analyses revealed adenocarcinoma（HR=3.020; 95% CI=1.340-6.805; P=0.008）, lymph node metastasis（HR=2.450;95% CI=1.065-5.637; P=0.035）, and high neutrophil density（HR=2.866; 95% CI=1.274-46.447; P=0.011） as independent prognostic factors of short RFS. Conclusion： The increasing number of tumor-infiltrating neutrophils in cervical cancer tissues was correlated with short RFS of patients with cervical cancer.