乳腺癌髓系来源抑制细胞与外周血单核细胞的相关性及对预后的影响

Correlation between myeloid-derived suppressor cells and peripheral blood monocytes counts in breast cancer and its effect on prognosis

目的探讨乳腺癌术后患者肿瘤浸润髓系来源抑制细胞(MDSCs)与外周血白细胞的相关性及对术后无复发生存时间(RFS)的影响。方法收集32例接受根治性手术的乳腺癌患者的临床病理资料及肿瘤浸润MDSCs比例,分析不同临床病理特征患者MDSCs比例差异。Spearman相关分析MDSCs与外周血白细胞的关系。根据MDSCs中位数将患者分为高MDSCs组(≥4.4%,16例)和低MDSCs组(<4.4%,16例),分析2组患者RFS的差异。结果不同临床病理特征患者中,仅Ⅲ期乳腺癌患者肿瘤浸润MDSCs比例高于Ⅰ~Ⅱ期患者(P<0.05)。肿瘤浸润MDSCs比例与外周血单核细胞计数、单核细胞/淋巴细胞比值(MLR)呈正相关(rs分别为0.405、0.408,均P<0.05)。总体分析结果显示,高、低MDSCs组RFS分别为(102.7±9.1)个月、(107.9±8.3)个月,差异无统计学意义(Log-rankχ2=1.166,P>0.05);分层分析结果显示,在17例无淋巴结转移患者中,高MDSCs组RFS明显较低MDSCs组缩短[平均RFS分别为(97.4±31.9)个月、(117.8±15.9)个月,Log-rankχ2=5.402,P<0.05]。结论乳腺癌肿瘤浸润MDSCs比例与外周血单核细胞计数、MLR呈正相关,无淋巴结转移患者高MDSCs组RFS更差。

Objective To investigate the correlation between tumor infiltrating myeloid-derived suppressor cells(MDSCs)and peripheral blood leukocytes in patients with breast cancer,and its effect on the relapse-free survival(RFS).Methods The clinical data and the proportion of tumor infiltrating MDSCs of 32 patients with breast cancer who underwent radical surgery in Tianjin Cancer Hospital were collected.The relationship between MDSCs and clinicopathological features was analyzed.The correlation between MDSCs and peripheral blood leukocytes was observed by Spearman correlation analysis.The patients were divided into the high MDSCs group(≥4.4%,n=16)and the low MDSCs group(<4.4%,n=16)according to the median MDSCs.The difference of RFS between the two groups was analyzed.Results The proportion of tumor infiltrating MDSCs was higher in patients with stageⅢthan that of patients with stageⅠ-Ⅱ(P<0.05).The proportion of MDSCs infiltrated by tumor was positively correlated with peripheral blood monocyte count(rs=0.405)and monocyte to lymphocyte ratio(MLR)(rs=0.408,P<0.05).Overall analysis results showed that RFS values of the high and low MDSCs groups were[(102.7±9.1)months and(107.9±8.3)months],and there was no significant difference between the two groups(Log-rankχ2=1.166,P>0.05).Stratified analysis showed that in 17 cases without lymph node metastasis RFS was significantly shorter in the high MDSC group[(97.4±31.9)months]than that of the low MDSCs group[(117.8±15.9)months,Log-rankχ2=5.402,P<0.05].Conclusion The proportion of MDSCs infiltrating in breast cancer is positively correlated with peripheral blood monocyte count and MLR.Patients without lymph node metastasis have worse RFS in the high MDSCs group.