结直肠癌三级淋巴结构的密度、成熟度与临床病理特征的关系

Relationship between density,maturity and clinicopathological features of tertiary lymphoid structure in colorectal cancer

目的探讨结直肠癌(CRC)三级淋巴结构(TLS)的密度、成熟度与临床病理特征、错配修复(MMR)蛋白的相关性。方法收集116例手术切除CRC病例,评估TLS的密度及成熟度并分组,分析TLS的密度及成熟度与临床病理特征、MMR的关系。结果在CRC中,TLS阳性率为84.48%(98/116),不同肿瘤TNM分期、肿瘤部位、肿瘤分化、淋巴结转移、MMR组间TLS的密度差异有统计学意义(P<0.05);TLS的密度与成熟度有相关性(r=0.321,P<0.05);不同肿瘤TNM分期、肿瘤部位、肿瘤分化组间TLS成熟度差异有统计学意义(P<0.05);肿瘤TNM分期越早、右半结肠、肿瘤分化越高,TLS密度、成熟度比例越高;TLS密度越高,TLS成熟度越高。结论TLS密度及成熟度与TNM分期、组织学分级、肿瘤发生部位等重要的临床病理因素密切相关,提示TLS作为机体免疫状态的重要指标,可能具有控制肿瘤发生发展的重要作用。

Objective To explore the correlation between the density and maturity of tertiary lymphoid structures(TLS)in colorectal cancer(CRC)and clinicopathological features and mismatch repair(MMR)proteins.Methods A total of116 cases of CRC resection were collected,and the density and maturity of TLS were evaluated and grouped to analyze the relationship between the density and maturity of TLS and clinicopathological features and MMR.Results In CRC,the positive rate of TLS was 84.48%(98/116),and there were significant differences in TLS density among different TNM stages,tumor sites,tumor differentiation,lymph node metastasis and MMR expression groups(P<0.05).The density of TLS was correlated with maturity(r=0.321,P<0.05).There were significant differences in TNM stage,tumor site and TLS maturity among different tumor differentiation groups(P<0.05).The earlier the TNM stage,the higher the right half colon,the higher the tumor differentiation,the higher the TLS density and maturity ratio.The higher the TLS density,the higher the TLS maturity.Conclusion TLS density and maturity are closely related to TNM stage,histological grade,tumor location and other important clinicopathological factors,suggesting that TLS,as an important indicator of immune status,may play an important role in controlling tumor occurrence and development.