肿瘤相关巨噬细胞在非肌层浸润性膀胱癌表达的临床意义

Clinical value of tumor-associated macrophages in non-muscle-invasive bladder cancer

目的:探讨肿瘤相关巨噬细胞(TAMs)在非肌层浸润性膀胱癌(NMIBC)表达情况及其临床意义。方法:收集147例NMIBC临床病例资料,运用免疫组织化学染色检测CD163+TAMs在癌组织表达密度,组间比较采用χ2检验,使用Kaplan-Meier法进行生存分析,并用Cox回归多因素模型对患者预后进行分析。结果:在单因素分析中,CD163+TAMs在癌间质低密度和中密度表达复发率分别为11.1%和12.4%,差异无统计学意义(P>0.05);将二者合并,与高密度(37.5%)复发率比较,差异有统计学意义(P<0.05)。进一步分层分析在吸烟、肿瘤多发、肿瘤直径<3cm、肿瘤分级G1和G2及肿瘤分期Ta的患者中,CD163+TAMs表达低中密度和高密度复发率比较,差异有统计学意义(P<0.05);而在性别、年龄、非吸烟、肿瘤单发、肿瘤直径≥3cm、肿瘤分级G3及肿瘤分期T1的患者中,CD163+TAMs表达低中密度和高密度复发率比较,差异无统计学意义(P>0.05)。结论:肿瘤间质中CD163+TAMs可以作为NMIBC临床预后的潜在指标。

Objective：To investigate expression of tumor-associated macrophages in non-muscle-invasive bladder cancer （NMIBC） and it＇s clinical value.Method：The clinical data were collected from 147 cases of NMIBC.The density of CD163-labeled TAMs （CD163＋TAMs） in cancer tissues and adjacent tissues were detected by immunohistochemical staining.The difference between the two groups was analyzed byχ2 test and survival analysis was performed using the Kaplan-Meier method.Cox regression multivariate model was used to analyze the prognosis of the patients.Result：The recurrence rates of CD163＋TAMs in low density and medium density were 11.1% and 12.4% （P〈0.05） by univariate analysis,the difference showed no statistical significance.The recurrence rate was statistically significant （P〈0.05） while mild degree combined with moderate degree compared with the interstitial high （37.5%）.In the further stratified analysis of recurrence rate,the degree of mildness and high of CD163＋TAMs showed statistical difference （P〈0.05） of smoking,multiple tumors,tumor diameter less than3.0cm,tumor grade for G1 and G2 and tumor stage for Tapatients.On the contrary,the above phenomena did not occur in gender,age,non-smoking,single tumor,diameter greater than 3.0cm,grade G3 and stage T1 patients.Conclusion：CD163＋TAMs in tumor stroma can be used as a potential prognostic indicator for NMIBC.