乳腺癌T淋巴细胞及CD68^(+)肿瘤相关巨噬细胞浸润的临床病理观察

Clinicopathological observation of T-lymphocyte and CD68^(+)tumor-associated macrophage infiltration in breast cancer

目的分析乳腺癌T淋巴细胞、CD68^(+)肿瘤相关巨噬细胞(TAM)浸润的临床病理意义。方法60例初治乳腺癌患者,以免疫组织化学法检测患者术后组织标本T淋巴细胞、CD68^(+)TAM表达情况及Ki-67增殖指数表达情况,分析光学显微镜下T淋巴细胞数、CD68^(+)TAM数。比较不同Ki-67增殖指数患者的T淋巴细胞、CD68^(+)TAM表达情况,分析T淋巴细胞数和CD68^(+)TAM数与临床特征的关系。结果Ki-67增值指数≥14%、≥20%、≥30%患者的T淋巴细胞低表达率比较差异无统计学意义(P>0.05);Ki-67增殖指数≥50%患者的T淋巴细胞低表达率85.71%高于Ki-67增值指数≥14%患者,差异具有统计学意义(P<0.05);Ki-67增殖指数≥14%、≥20%、≥30%、≥50%患者的CD68^(+)TAM低表达率对比差异无统计学意义(P>0.05)。不同年龄、组织学分级、HER2(-或+)患者的T淋巴细胞数比较差异均无统计学意义(P>0.05);肿块直径≤3 cm患者的T淋巴细胞数(175.05±20.50)个/HPF高于>3 cm患者的(148.50±18.50)个/HPF,淋巴转移阴性患者的T淋巴细胞数(174.50±20.50)个/HPF高于阳性患者的(147.02±22.20)个/HPF,ER+患者的T淋巴细胞数(182.20±10.30)个/HPF高于ER-患者的(133.30±10.50)个/HPF,PR+患者的T淋巴细胞数(179.50±14.50)个/HPF高于PR-患者的(165.40±24.50)个/HPF,差异具有统计学意义(P<0.05)。不同肿块直径、ER(-或+)、PR(-或+)患者的CD68^(+)TAM数比较差异均无统计学意义(P>0.05);年龄≤51岁患者的CD68^(+)TAM数(90.95±9.50)个/HPF高于>51岁患者的(83.30±8.08)个/HPF,组织学分级Ⅲ级患者的CD68^(+)TAM数(91.55±8.50)个/HPF高于Ⅰ~Ⅱ级患者的(85.20±8.80)个/HPF,淋巴转移阳性患者的CD68^(+)TAM数(90.99±9.02)个/HPF高于阴性患者的(84.50±9.60)个/HPF,HER2+患者的CD68^(+)TAM数(92.30±8.20)个/HPF高于HER2-患者的(84.08±8.50)个/HPF,差异具有统计学意义(P<0.05)。结论浸润CD68^(+)TAM与乳腺癌的进展关系密切,有助于临床工作的开展。

Objective To analyze the clinicopathological significance of T-lymphocyte and CD68^(+)tumor-associated macrophage(TAM)infiltration in breast cancer.Methods In 60 patients with newly diagnosed breast cancer,the expression of T lymphocytes and CD68^(+)TAM in postoperative tissue specimens and the expression of Ki-67 proliferation index were detected by immunohistochemistry,and the T lymphocyte count and CD68^(+)TAM count were analyzed under light microscopy.The expression of T lymphocytes,CD68^(+)TAM in patients with different Ki-67 proliferation indices was compared and the correlation between T lymphocyte count and CD68^(+)TAM count and clinical characteristics was analyzed.Results There was no statistically significant difference in the low expression rate of T lymphocytes among patients with Ki-67 proliferation index≥14%,≥20%,and≥30%(P>0.05).The low expression rate of T lymphocytes in patients with Ki-67 proliferation index≥50%was 85.71%,which was higher than that in patients with Ki-67 proliferation index≥14%,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the low expression rate of CD68^(+)TAM in patients with Ki-67 proliferation index≥14%,≥20%,≥30%,and≥50%(P>0.05).There was no statistically significant difference in the T lymphocytes count among patients with different age,histological grade and HER2(-or+)(P>0.05).The T lymphocytes count in patients with tumor diameter≤3 cm was(175.05±20.50)cells/HPF,which was higher than(148.50±18.50)cells/HPF in patients with tumor diameter>3 cm;the T lymphocytes count in patients with negative lymph node metastasis(174.50±20.50)/HPF,which was higher than(147.02±22.20)/HPF in patients with positive lymph node metastasis;the T lymphocytes count in ER+patients was(182.20±10.30)/HPF,which was higher than(133.30±10.50)/HPF in ER-patients;the T lymphocytes count in PR+patients was(179.50±14.50)/HPF,which was higher than(165.40±24.50)/HPF in PR-patients;the differences were all statistically significant(P<0.05).There was no statistically significant difference in CD68^(+)TAM count among patients with different tumor diameters,ER(-or+),and PR(-or+)(P>0.05).The CD68^(+)TAM count in patients aged≤51 years was(90.95±9.50)/HPF,which was higher than(83.30±8.08)/HPF in patients>51 years old;the CD68^(+)TAM count in patients with histological gradeⅢwas(91.55±8.50)/HPF,which was higher than(85.20±8.80)/HPF in patients with histological gradeⅠ-Ⅱ;the CD68^(+)TAM count in lymph node metastasis-positive patients was(90.99±9.02)/HPF,which was higher than(84.50±9.60)/HPF in lymph node metastasis-negative patients;the CD68^(+)TAM count in HER2+patients was(92.30±8.20)/HPF,which was higher than(84.08±8.50)/HPF in HER2-patients;the differences were all statistically significant(P<0.05).Conclusion CD68^(+)TAM infiltration and breast cancer progression are closely related,which is helpful to the development of clinical work.