口腔癌组织中VEGF与DC成熟及Treg关系的临床观察

Clinical observation of vascular endothelial growth factor and DC maturation and Treg in oral cancer

目的探讨口腔癌组织中血管内皮生长因子(VEGF)、树突状细胞(DC)分化成熟和调节性T细胞(Treg)表达,并分析影响口腔癌复发的因素。方法收集2015年1月至2015年6月间的67例患者的临床病例资料,随访患者复发情况。采用免疫组化SP法检测口腔癌组织中VEGF、CD83、CD1α+、Foxp3的表达情况,分析其表达与口腔癌术后复发的关系,采用Cox回归模型分析影响口腔癌复发的独立因素。结果口腔癌组织中VEGF阳性表达率为59. 7%(40/67),与肿瘤发生部位、TNM分期和肿瘤体积有关(P<0. 05)。CD83和Foxp3阳性表达率分别为52. 2%(35/67)和38. 8%(28/67),与TNM分期和淋巴结转移有关(P<0. 05)。CD1α阳性表达率为41. 8%(26/67),与TNM分期有关(P<0. 05)。术后平均随访(31. 45±6. 23)个月,其中21例(31. 34%)患者复发,复发患者和未复发患者TNM分期、淋巴结转移、VEGF表达情况、CD83+、CD1α+树突状细胞分布情况以及Foxp3+T细胞分布情况之间差异存在统计学意义(P<0. 05)。经Spearman秩相关分析,VEGF表达与CD83+树突状细胞分布呈负相关,而与Foxp3+T细胞分布呈正相关(P<0. 05); CD83+和CD1α+树突状细胞分布呈负相关(P<0. 05); Foxp3+T细胞分布与CD1α+树突状细胞分布呈正相关(P<0. 05)。多因素Cox回归模型分析显示,TNM分期晚、淋巴结转移、VEGF阳性表达、CD1α+低分布、Foxp3+高分布是术后复发的独立危险因素(P<0. 05)。结论肿瘤微环境中VEGF与成熟DCs数量减少有关,而不成熟DCs与Treg细胞的分布呈正相关,可作为判断口腔癌患者预后的参考指标。

Objective To investigate the expression of vascular endothelial growth factor （VEGF）, dendritic cell （DC） differentiation and regulatory T cells （Treg） in oral cancer, and to analyze the factors that affect the recurrence of oral cancer.Methods The clinical data of 67 patients from January 2015 to June 2015 were collected. The recurrence of the patients was followed up. The expression of VEGF, CD83, CD1αand Foxp3 in oral cancer tissues was detected by immunohistochemical SP, and the relationship between the expression and recurrence of oral cancer was analyzed. The independent factors affecting the recurrence of oral cancer were analyzed by Cox regression model.Results The positive expression rate of VEGF in oral cancer tissues was 59.7% （40/67）, which was related to tumor location, TNM stage and tumor volume （ P 〈0.05）. The positive expression rates of CD83 and Foxp3 were 52.2% （35/67） and 38.8% （28/67）, respectively, which were related to TNM staging and lymph node metastasis （ P 〈0.05）. The positive expression rate of CD1 alpha was 41.8% （26/67）, which was related to TNM stage （ P 〈0.05）. The mean follow-up period was （31.45±6.23） months, and 21 patients relapsed. There were significant differences in TNM staging, lymph node metastasis, VEGF expression, CD1α, CD1 alpha＋ dendritic cell distribution and the distribution of Foxp3＋T cells in recurrent and non recurrent patients （ P 〈0.05）. The Spearman rank correlation analysis showed that VEGF expression was negatively correlated with the distribution of CD83＋ dendritic cells, but positively correlated with the distribution of Foxp3＋T cells （ P 〈0.05）, and the distribution of CD83＋and CD1α＋ dendritic cells was negatively correlated （ P 〈0.05）, and the distribution of Foxp3＋T cells was positively correlated with the distribution of CD1α＋ dendritic cells （ P 〈0.05）. The analysis of multiple factor Cox regression model showed that TNM staging, lymph node metastasis, VEGF positive expression, CD1α＋ low distribution and high Foxp3＋distribution were independent risk factors for postoperative recurrence （ P 〈0.05）.Conclusion VEGF in the tumor microenvironment is related to the decrease in the number of mature DCs, but the distribution of immature DCs is positively correlated with the distribution of Treg cells, which can be used as a reference index to judge the prognosis of oral cancer patients.