CD68巨噬细胞浸润对原发性食管小细胞癌预后的影响

Impact of CD68 macrophage infiltration on prognosis in primary small cell esophageal carcinoma

目的:探讨不同亚型肿瘤相关巨噬细胞在原发性食管小细胞癌(PESC)中的浸润情况及其与患者临床病理指标和预后的关系。方法:回顾性分析汕头大学医学院附属肿瘤医院2000年1月—2019年12月进行手术治疗且临床病理资料完整的69例PESC患者组织标本。采用免疫组织化学法评估CD68巨噬细胞及CD163巨噬细胞在PESC中的浸润情况,卡方检验和Fisher精确检验分析其与PESC临床病理指标的关系,采用Kaplan-Meier生存分析及多因素Cox回归方法分析各检测指标与患者生存预后的关系。结果:CD68及CD163均在巨噬细胞的胞质或胞膜表达。CD68巨噬细胞与肿瘤T分期有关(χ^(2)=6.336,r=-0.303,P=0.012),与其他各临床病理指标均无明显相关。PESC患者的p TNM分期、手术淋巴结清扫数目、N分期、辅助性化疗及CD68巨噬细胞浸润情况与总生存期有关(P<0.05)。多因素Cox回归分析结果显示pTNM分期、手术淋巴结清扫数目、CD68巨噬细胞是PESC患者独立的预后因素。与CD68巨噬细胞低浸润组相比,CD68巨噬细胞高浸润患者的死亡风险降低[HR=0.340,95%CI(0.179,0.645),P=0.001]。结论:CD68巨噬细胞高浸润是PESC患者独立的预后影响因素,CD68巨噬细胞高浸润的患者预后明显优于CD68巨噬细胞低浸润的患者。

OBJECTIVE:To investigate infiltrations of different subtypes of tumor-associated macrophages in primary esophageal small cell carcinomas(PESC),and their relationships with clinico-pathological parameters and prognosis.METHODS:Clinico-pathological data of PESC from January 2000 to December 2019 in Cancer Hospital of the Shantou University Medical College were analyzed retrospectively.Infiltrations of the CD68 and CD163 macrophages were evaluated by immunohistochemistry.The Chi-square and Fisher’s exact tests were used to evaluate their relationships with the clinico-pathological indices.Furthermore,Kaplan-meier and Multivariate Cox regression were used to analyze prognosis for PESC.RESULTS:CD68-and CD163-stained macrophages were located in cytoplasmic or membrane of tumor cells.CD68 macrophage infiltrations,specifically,were correlated with tumor T stages(χ^(2)=6.336,r=-0.303,P=0.012).However,the infiltrations showed no association with the other clinico-pathological variables.Kaplan-meier analyses showed that the pTNM stage,number of surgical lymph node dissection,N stage,adjuvant chemotherapy and infiltration were associated with overall survival(P<0.05).Multivariate Cox regression analyses showed that pTNM stage,the number of lymph node dissection and the infiltration were independent prognostic factors.High infiltrations were significantly associated with overall survival compared with low infiltrations(Hazard ratio=0.340,95%confidence interval 0.179-0.645;P=0.001).CONCLUSION:High infiltration of CD68macrophages,but not CD163,was an independent prognostic factor for patients with PESC.Patients with high infiltrations had significantly favorable prognoses than those with low infiltration of CD68 macrophages.