喉癌颈淋巴结抗肿瘤免疫状态的研究

Immune responses against cancers in cervical lymph nodes of laryngeal carcinoma

目的 通过对肿瘤引流淋巴结中增生性滤泡反应和树突状细胞 (dendriticcell,DC)浸润密度进行定量分析 ,探讨其在喉癌患者抗肿瘤免疫反应中的作用。方法 重新制备 4 7例行选择性颈淋巴结清扫术的喉癌患者的 15 7枚颈淋巴结石蜡切片 ,用抗S 10 0、CD4 5RO和CD2 0单克隆抗体免疫组化抗生物素 生物素过氧化物酶复合物 (avidin biotinperoxidase,ABC)法显示DC和增生性滤泡的分布并检测其密度。根据增生性滤泡反应的特点进行分型研究。结果 增生型滤泡反应的程度与类型和DC浸润密度有明显的相关性。术后生存 5年以上的患者淋巴结中滤泡计数和DC浸润密度明显多于生存期少于 5年者 (P <0 0 0 1)。无淋巴结转移组患者淋巴结中的滤泡计数和DC浸润密度较有转移组亦有明显增加 (P <0 0 0 1)。具有T细胞增生型滤泡反应的患者比T细胞非增生型患者有较高的 5年生存率 (P <0 0 1)和较低的淋巴结转移率 (P <0 0 5 )。结论 颈淋巴结中增生性滤泡反应和树突状细胞的浸润反映了机体免疫系统的抗肿瘤潜能。树突状细胞的浸润密度和增生性滤泡反应的程度及分型反映了该患者的抗肿瘤免疫状态 ,可以共同作为预后判定的重要指标。

Objective Densities of dendritic cells(DC) and hyperplastic follicular response in cervical lymph nodes were performed to prove their roles in immune responses against cancers Methods Paraffin blocks were prepared for staining with monocloned antibodies against CD45RO, CD20 and S 100 proteins,in 157 lymph nodes obtained from elective cervcial lymphadenectomy in 47 cases of laryngeal squamous cell carcinomas Results Quantitative analysis showed that the patients who survived longer than 5 years had significant higher number of follicles and higher extent of infiltration by DCs in the lymph nodes than those who less than 5 years ( P <0 001) According to negative or positive lymph node metastasis, there were statistically significant differences between two groups ( P <0 001) The patients who possessed T cell increase type follicular reaction had significant higher five year survival rate ( P <0 01) and lower lymphnode metastasis rate ( P <0 05) than those who possessed T cell decrease type reaction Conclusion DCs and hyperplastic follicular response may be more directly involved in the host immune reaction against tumor The classification of follicular reaction, the densities of DCs and follicular reaction, can serve as important indicators in assessing prognosis of laryngeal carcinomas