大剂量阿糖胞苷短疗程化疗方案在儿童急性淋巴细胞白血病的临床应用总结

目的总结应用包括大剂量阿糖胞苷(Ara-C)的短疗程化疗方案治疗儿童急性淋巴细胞白血病(ALL)的临床疗效。 方法总结1992-01—2001-07在北京大学人民医院儿科初治并长期随访的ALL患儿84例，其中男52例，女32例，长期无病生存(EFS)5年以上，随访 时间至2006-07。 结果标危型患儿EFS率79.59%，高危型患儿的EFS率为25.81%；长期存活患儿中最长EFS为14年6个月，最短EFS为5年，中位EFS为9年11个月。有6 例发生中枢神经系统白血病。未出现与大剂量Ara-C化疗相关的患儿死亡。 结论(1)采用包括大剂量Ara-C的短疗程化疗方案能够获得较高的完全缓解率及EFS率，且副反应小。(2)采用该短疗程方案不加用颅脑放疗，中 枢神经系统白血病的发生率无提高。(3)ALL患儿对Ara-C的敏感性存在明显的个体差异。     

干/髓系免疫表型对儿童T-急性淋巴细胞白血病预后影响研究

探讨干/髓系表面抗原标记对儿童T-急性淋巴细胞白血病的预后影响。方法　回顾性分析2002-01-01至2008-12-31上海交通大学医学院附属儿童医学中心收诊的57例T细胞型急性淋巴细胞白血病（ALL）和伴有骨髓转移的T细胞性淋巴母细胞型非霍奇金淋巴瘤（NHL）患儿干/髓系表面抗原表达情况,将其分为T-ALL伴有髓系表达组（T/My+ALL）和无髓系表达组（T/My-ALL）,分析其与预后的相关性。结果　T/My+ALL组31例（54.6%）和T/My-ALL组26例（45.4%）,两组细胞形态学、遗传学及临床特征差异均无统计学意义（P > 0.05）;近期疗效中,泼尼松诱导实验差异无统计学意义（P > 0.05）,19d骨髓象及第1疗程完全缓解率T/My+ALL组均较T/My-ALL组低,差异有统计学意义（P 值分别为0.002和0.006）;T/My+ALL组和T/My-ALL组的初治完全缓解率分别为90.3%和96.2%,5年无事件生存率分别为35.4%和65.7%。虽结果提示T/My+ALL组预后较T/My-ALL组差,但差异无统计学意义（P = 0.209）。结论　T-ALL/NHL伴有干/髓系表面抗原表达时预后差,但未达到统计学有效意义,目前尚不能将之作为儿童T系淋巴细胞白血病的预后因素。     

Daxx蛋白在儿童急性白血病骨髓细胞中的表达意义

目的探究Daxx蛋白在儿童急性白血病骨髓细胞中的表达意义。方法2010年2月至2014年10月汕头大学医学院第一附属医院儿科收治住院的急性白血病患儿100例为观察组,又根据疾病类型分为3个亚组,即急性淋巴细胞白血病(ALL)组49例,急性非淋巴细胞白血病(ANLL)组21例,急性髓细胞白血病(AML)组30例。对照组30例,为同年龄正常健康儿童。采用免疫组织化学方法检测Daxx蛋白的表达。结果对照组儿童骨髓细胞中Daxx蛋白的表达阳性率与ALL组比较差异无统计学意义(P0.008 3);对照组儿童骨髓细胞中Daxx蛋白的表达阳性率显著低于ANLL组和AML组,差异有统计学意义(P0.008 3)。对照组中Daxx蛋白在儿童急性白血病骨髓中的表达(6.01±1.13)μg/L,显著高于ALL组(3.55±2.32)μg/L、ANLL组(3.54±2.47)μg/L、AML组(3.12±1.56)μg/L,差异有统计学意义(P0.05)。结论 Daxx蛋白在儿童急性白血病骨髓细胞中过度表达,可能对促进白血病细胞的增殖、生长过程起到重要作用。     

髓系抗原阳性儿童急性淋巴细胞白血病临床特点及预后

目的分析髓系抗原阳性儿童急性淋巴细胞白血病(ALL)的临床特点及预后关系。 方法根据国际白血病欧洲协作组(EGIL)标准将1999—2004年上海交通大学医学院附属上海儿童医学中心收治的33例髓系抗原阳性表达的ALL (My+ALL)分为双表型、双系列型给予正规治疗。对其预后进行观察。 结果(1)My+ALL患儿，双表型26例(78.8%，26/33)，其中B系ALL伴髓系表达17例(65.4%，17/26)，T系ALL伴髓系表达6例(23.1%,6/26)，T系B系 伴髓系表达3例(11.5%,3/26)。双系列ALL患儿7例(21.2%,7/33)。(2)26例双表型ALL患儿治疗35d，缓解率80.7%。7例双系列型ALL仅1例达缓解 (14.3%)。(3)生存状态：双表型26例中20例处于缓解状态(76.9%)，双系列型7例中仅1例(14.3%)。(4)复发情况：双表型6例复发(23.1%，6/26) ，双系列7例中6例复发(85.7%)。 结论髓系抗原阳性表达在儿童ALL时不能作为预后不良的因素，但双系列白血病患儿预后差，复发率高，长期生存机会少。     

20(S)-人参皂苷Rg3对卵巢癌生长抑制作用的实验研究

目的探讨过敏性紫癜(HSP)患儿尿表皮生长因子(EGF)质量浓度检测及其对早期肾损害的诊断价值。 方法91例HSP患儿为山东省青岛市妇女儿童医疗保健中心2003 01—2004 12住院确诊患儿，采用双抗体夹心ELISA方法检测HSP患儿和30例正常对照组儿童的尿EGF和尿视黄醇结合蛋白(RBP)质量浓度，同时采用全自动特殊蛋白分析仪测定尿微量白蛋白(MA)质量浓度。 结果(1)HSP患儿尿EGF质量浓度\[(78.59±18.09)ng/mL\]明显高于正常对照组\[(29.30±13.92)ng/mL\]，差异有显著性(t值为13.64，P<0.01)。HSP各临床分型间比较发现紫癜肾型尿EGF质量浓度\[(98.31±17.68)ng/mL\]分别高于其它临床型：皮肤型\[(78.76±12.66)ng/mL\]、腹型\[(77.16±11.77)ng/mL\]、关节型\[(76.49±17.45)ng/mL\]、混合型\[(77.71±13.49)ng/mL\]，差异均有显著性意义(P均＜0.05)，而其余各临床分型间比较差异无显著性(P均＞0.05)。(2)HSP患儿尿MA质量浓度为(43.21±10.23)mg/L，明显高于正常对照组\[(6.41±2.86)mg/L\]，两者比较差异有显著性(t′=25.91，P<0.01)。(3)HSP患儿尿RBP质量浓度为(46.8±20.9)ng/mL，明显高于正常对照组\[(12.8±4.8)ng/mL\]，差异有显著性(t′=11.98，P<0.01)。(4)91例急性期受检患儿中尿常规异常者14例(15.38%)，尿MA升高者37例(61.67%)，尿RBP升高者45例(75%)，尿MA和(或)RBP升高者51例(85%)，尿EGF升高者84例(92.3%)，尿EGF阳性率与文献报道肾活检的相仿。 结论HSP患儿尿EGF、RBP、MA质量浓度均明显增高，EGF在HSP伴有肾损害者早期升高尤为明显，考虑EGF增高可能与HSP病理改变程度有关，因此，EGF增高可作为HSP早期肾损害的敏感指标之一。     

儿童急性淋巴细胞白血病Bcl-2基因表达及其临床意义

目的探讨儿童急性淋巴细胞白血病(ALL)Bcl-2基因表达与临床的相关性。 方法青岛大学医学院附属医院儿科2000年10月至2001年10月利用细胞原位杂交技术，检测了30例ALL患儿不同时期Bcl-2mRNA阳性表达， 探讨其与ALL发生、治疗反应、疗效等的关系。 结果93.3%(28/30)ALL患儿有Bcl-2mRNA阳性表达，正常对照组均无表达；经1周泼尼松治疗后，细胞凋亡指数均升高，低表达组升高明显，外周血WBC下降明显；第19d骨髓检查，低表达组完全缓解率高，为90.5%(19/21)，而高表达组仅为33.3%(3/9)；动态观察10例ALL患儿，发现5例高危型患儿表达始终在较高水平，有3例在1年内出现中枢神经系统白血病，2例骨髓复发。 结论ALL患儿普遍存在Bcl-2mRNA表达，Bcl-2基因参与ALL发生；Bcl-2mRNA表达水平与泼尼松治疗反应关系密切，泼尼松治疗1周可作为化疗敏感试验；Bcl-2mRNA表达水平与第19d骨髓完全缓解率有明显相关性，高表达者完全缓解率低；动态检测Bcl-2mRNA表达水平可作为化疗敏感性的指标，指导临床采用个体化的化疗方案，同时可为临床判断预后提供可靠依据。     

喘息与非喘息型病毒性肺炎患儿淋巴细胞亚群的研究

目的了解喘息与非喘息型病毒性肺炎患儿淋巴细胞亚群的改变。 方法对2002—2004在北京友谊医院就诊的急性期喘息型病毒性肺炎患儿37例及非喘息型病毒性肺炎患儿32例，采用流式细胞仪对其外周血淋巴细胞亚群进行检测。并以30例健康儿童作为对照组。 结果喘息组与非喘息组病毒性肺炎患儿急性期外周血T辅助淋巴细胞亚群Th1细胞百分率分别为(12.61±7.19)%及(17.32±9.92)%，与对照组\[(9.16±9.90)%\]比较差异均有显著的统计学意义(P<0.001)；喘息组与非喘息组患儿Th1/Th2比值均高于对照组(P<0.05，P<0.01)。此外与非喘息组比较，喘息组CD+4/CD+8较高(P<0.05)，但其他各项指标差异均无统计学意义。 结论病毒性肺炎时不论是否发生喘息，均呈现Th1应答优势。喘息型病毒性肺炎患儿除CD+4/CD+8较非喘息型病毒性肺炎高外，其他各项淋巴细胞亚群差异无明显统计学意义。     

ALL患儿经SCCLG-2016方案治疗后复发的相关因素分析

目的分析急性淋巴细胞白血病(ALL)患儿经华南地区儿童急性淋巴细胞白血病治疗协作组2016方案(SCCLG-2016)治疗后复发的相关因素。方法选择2016年8月至2017年8月深圳市儿童医院血液肿瘤科收治ALL患儿364例为研究对象,分析364例接受SCCLG-2016方案治疗的结果,随访复发情况和相关病理资料,采用Logistics回归分析影响其治疗后复发的独立危险因素。结果 364例ALL患儿复发率为18.68%(68/364),复发组与未复发组患儿年龄、白细胞数目、融合基因阳性率、微小残留病变及危险度分级比较差异均有统计学意义(P0.05),其中年龄≥10岁、白细胞数目≥100×10~9/L和BCR/ABL基因阳性、危险分级为高危者是影响ALL患儿治疗后复发的独立危险因素。结论年龄≥10岁、白细胞数目≥100×10~9/L及融合基因阳性、危险分级为高危是ALL患儿经SCCLG-2016方案治疗后复发的独立危险因素,治疗时密切关注以上因素,有利于识别复发概率较高者,早期干预。     

大剂量甲氨蝶呤在儿童急性淋巴细胞白血病不同庇护所预防治疗中的作用

目的研究不同的庇护所预防方案对儿童急性淋巴细胞白血病(ALL)的治疗作用以及其副反应。 方法2001-03—2003-03在首都医科大学附属北京儿童医院住院治疗的ALL患儿259例，标危组122例，以大剂量甲氨蝶呤(HD MTX，每次3g/m2)治疗，共1089例次；高危组137例，共765例次；高危组HD MTX治疗，分为2组，A组60例方案同标危组，B组77例采用HD MTX(每次3g/m2，用3次)，半年后颅脑放疗18Gy。所有患儿中用药方法分为连续6h静滴MTX(814例次)，24h连续静滴MTX(1040例次)两组。 结果高危组患儿与标危组患儿相比肝功能损害、骨髓抑制以及感染较高(均P<005)；高危组中A组与B组的庇护所预防效果差异无显著性意义(P>005)，连续6h静滴MTX与连续24h静滴，两组间MTX的副反应以及排泄延迟发生率无显著性意义(P>005)。 结论在精确对ALL危险度分型的基础上，一部分高危患儿可以取消颅脑放疗，24h连续静滴HD MTX可以取代6h静滴是安全可行的。     

急性淋巴细胞白血病患儿化疗期疲乏症状调查

目的调查急性淋巴细胞白血病患儿化疗期疲乏症状状况。方法采用便利抽样法对2014年2月至2016年8月在郑州市儿童医院血液肿瘤科治疗的ALL化疗期患儿216例及其家长进行问卷调查。根据化疗不同治疗阶段分为3组,首次化疗组68例,非首次化疗组88例,化疗间歇期组60例。采用中文版PedsQL儿童多维疲乏量表对全身疲乏、休息疲乏、认知疲乏症状各维度进行评分。结果 ALL患儿化疗期间疲乏症状总分为(33.19±23.17)分,其中全身疲乏维度平均得分为(11.94±7.59)分,睡眠疲乏维度平均得分为(11.80±7.70)分,认知疲乏维度平均得分为(9.45±7.88)分。患儿在化疗间歇期疲乏得分均高于首次化疗和非首次化疗,差异均有统计学意义(P0.05)。结论急性淋巴细胞白血病患儿化疗期疲乏症状普遍存在,其中全身疲乏和睡眠疲乏症状处于中等水平,认知疲乏症状处于中等偏下水平;急性淋巴细胞白血病患儿化疗期不同治疗阶段疲乏症状存在差异,医务人员应该对不同疲乏症状进行评估并提供针对性症状管理。     

A subset of acute lymphoblastic leukemia with co-expression of myeloid antigens: prevalence and clinical significance.

In order to evaluate the biological features and clinical significance of myeloid antigen expression in acute lymphoblastic leukemia (ALL), immunophenotype analysis was performed on leukemic cells from 160 patients diagnosed as ALL by the French, American and British (FAB) criteria using a comprehensive panel of monoclonal antibodies to lymphoid and myeloid associated antigens. Expression of myeloid antigens was found in 32 cases (20%), including 11 out of 49 adults (22.4%) and 21 out of 111 children (18.9%). CD33 was positive in 18 patients (11.3% of the total cases), CD13 in 15 patients (9.4%), CD 11b in 12 patients (7.5%) and CD14 in 1 patient (0.6%). Nine patients expressed two or more myeloid antigens. There were no significant differences in clinical manifestations and hematological pictures between the ALL patients with myeloid antigen expression (My+ ALL) and those without (My- ALL). No consistent chromosomal abnormality was found in My+ ALL. Eighty percent of the childhood and 44.4% of the adult My+ ALL patients achieved complete remission, compared with 87% and 80%, respectively, for childhood and adult My- ALL, but the differences were not statistically significant. After a median follow-up of 2.1 years, there were also no statistically significant associations between myeloid antigen expression and shorter duration of remission or poorer survival rate for patients with both adult and childhood ALL.     

High incidence of CD56 expression and relapse rate in acute myeloid leukemia patients with t(8;21) in Taiwan.

BACKGROUND AND PURPOSE: CD56 is a marker of natural killer cells, but can also be found on blast cells in acute myeloid leukemia (AML). The prognostic implications of CD56 expression in AML are not clear. In this study, we evaluated the correlation among CD56 expression, cytogenetic abnormality, and clinical outcome in AML. METHODS: CD56 expression was analyzed in leukemic cells from 94 adults with primary AML in Taiwan and was correlated with clinical and hematologic features, cytogenetics, and immunophenotypes of the leukemia. RESULTS: Thirty patients (32%) showed CD56 expression. CD56+ AML patients had a higher lactate dehydrogenase level than CD56- patients (1.136 vs 730 V/L, p = 0.048). Patients with t(8;21) had a significantly higher incidence (89%, 8/9) of CD56 positivity in leukemic cells than those with normal karyotype or other cytogenetic abnormalities (26%, 22/85, p < 0.001). In general, there was no difference in overall survival time in CD56+ and CD56- AML patients. However, three patients had central nervous system involvement at initial presentation; two of these had concomitant CD56 expression and t(8;21). In addition, five of the seven patients with t(8;21) and CD56 expression who achieved complete remission later relapsed. CONCLUSIONS: The incidence of CD56 expression in AML patients with t(8;21) is very high in Taiwan, and it may imply a poor prognosis in this subgroup of patients.     

Cytogenetic pattern of childhood leukemia in Taiwan.

BACKGROUND: Cytogenetic analyses of leukemic cells can be used to define specific subgroups of leukemia with different prognoses and, thereby, indicate appropriate treatment for individual cases. In this study, we investigated the cytogenetic pattern of childhood leukemia in Taiwanese patients. METHODS: A modified trypsin method of Seabright was used for G-banding of metaphase cells. RESULTS: From October 1996 to January 1999, 111 children with a diagnosis of leukemia were enrolled in the study. Of these, 73 patients had a diagnosis of acute lymphoblastic leukemia (ALL) and 63 of these patients had successful karyotyping of their leukemic cells. Among them, 20 (30.3%) had a normal karyotype, five had hypodiploidy (all had 45 chromosomes), five had low hyperdiploidy (47-50 chromosomes), 16 (24.2%) had high hyperdiploidy (> 50 chromosomes), and 20 had pseudodiploidy. Chromosomal translocation was identified in 24 (36.4%) of the ALL patients, 17 of whom had recurrent translocations including 10 with CD10+ B-precursor ALL [4 with t(9;22), 5 with t(1;19), and 1 infant with t(8;14)(q24;q11)], one neonate with CD10- early pre-B ALL with t(4;11), three B-cell cases with t(8;14), and three T-cell cases [2 with t(11;19)(q23;p13), and 1 (11;14)(p13;q11)]. One B-precursor patient had dic (9;12). Karyotypes of the 30 patients with acute myeloid leukemia (AML) included eight with t(8;21); seven with the French-American-British-M2 subtype (FAB-M2) and one with M1. All four of the patients with M3 had t(15;17), one patient with M4 had inv(16) and 7q-, one with M4Eo (M4 with eosinophilia) had t(7;16)(q21;q22), one with M0 had t(4;11)(q21;q23), and the remaining 11 had a normal karyotype. Three of the five adult-type chronic myeloid leukemia patients had standard Philadelphia chromosome, and the other two had a variant-form of Philadelphia chromosome. Both of the patients with juvenile myelomonocytic leukemia and one patient with myelodysplastic syndrome had a normal karyotype. CONCLUSIONS: Most findings were similar to previous reports. Although the high proportion of FAB-M2 patients (7/8) with t(8;21) and the consequently higher frequency (26.7%) of this translocation in the 30 AML cases in this study might have significance, a larger series of cases is needed to establish this finding.     

Distinct Differences in the Induction of Stimulus-mediated Superoxide Generation by Polymorphonuclear Neutrophils Isolated From Patients With Different Types of Leukemia

Background/Purpose: Accumulating literature has documented that there exists a distinct difference in nitro blue tetrazolium reduction capacity by the polymorphonuclear neutrophils (PMNs) from patients with different types of leukemia. The underlying mechanism associated with this observed phenomenon remains to be clarified. Methods: The production of O2-, monitored by a validated probe (lucigenin)-based ultraweak chemiluminescence, in resting and/or phorbol-1,2-myristate-1,3-acetate (PMA)- and zymosan-stimulated systems of various leukemic PMNs was measured. In parallel with these studies, we also quantified superoxide dismutase isozymes (Cu, Zn-SOD, Mn-SOD) from these isolated PMNs by established methods. Results: A marked increase was observed in O2- generation by the PMNs from patients with acute myeloid leukemia (AML), and chronic myeloid leukemia (CML), but not from patients with acute lymphocytic leukemia (ALL) when compared with controls either in the resting condition or after being stimulated by either PMA or zymosan. In parallel, we also quantified SOD isozyme activities and found that the total and CuZn-SOD of PMNs from AML were indeed significantly lower than either controls or ALL, implying that higher levels of O2- generation might result from a deficiency in this O2- metabolizing enzyme. Conclusion: Our data suggest that a distinct difference in the capability of O2- generation under stimulated conditions between PMNs from ALL and AML (or CML) may be of potential taxonomic or even therapeutic usefulness.     

宫颈淋巴瘤样病变与淋巴造血组织肿瘤临床病理对比分析#br#

目的探讨宫颈淋巴瘤样病变(LLL)与淋巴造血组织肿瘤的临床病理学特征、诊断及鉴别诊断。方法收集2007年10月至2021年8月北京大学人民医院病理科诊断的LLL20例,髓细胞肉瘤5例,B淋巴母细胞淋巴瘤/白血病1例,非霍奇金淋巴瘤4例。应用光镜观察、免疫组化染色、EBER原位杂交进行分析。结果中位年龄45岁,9例小于40岁。临床表现为阴道出血。宫颈黏膜表层可见炎症细胞及淋巴细胞,灶片状大细胞。CD20、CD3、CD138等部分阳性,Kappa、Lambda无轻链限制性。随访均健在。淋巴造血组织肿瘤中位年龄54.5岁,6例为绝经后。临床表现:阴道出血,宫颈肿物等。可见弥漫增生的淋巴样细胞,髓细胞肉瘤细胞原始,表达MPO、CD43、CD117等。B淋巴母细胞淋巴瘤/白血病细胞原始,表达CD20、PAX5、Td T等。弥漫性大B细胞淋巴瘤表达及黏膜相关淋巴组织边缘区B细胞淋巴瘤表达CD20。5例死亡(50%)。结论宫颈淋巴瘤样病变预后良好,应与淋巴瘤鉴别。临床病史、病理形态和免疫组化对于诊断女性生殖道淋巴造血组织肿瘤具有重要作用。     

Neoplastic disorders of hematopoiesis in children with Down's syndrome--a single institution experience in Taiwan.

BACKGROUND AND PURPOSE: Children suffering from Down's syndrome (DS) are predisposed to the development of neoplastic disorders of the hematopoietic system and tend to display many unique characteristics. This study analyzed the clinical characteristics and treatment outcomes of 16 children with DS who developed neoplastic disorders. METHODS: All DS patients aged < 18 years of age with a diagnosis of leukemia or myelodysplastic syndrome (MDS) from 1990 to 2002 were included in this retrospective study. The clinical and laboratory characteristics of patients, including age at diagnosis, gender, initial hemogram, cytogenetic findings, immunophenotype, treatment regimen and outcomes were analyzed. RESULTS: Sixteen patients met the inclusion criteria. Among them, 9 patients (56%) had acute myeloid leukemia (AML), mainly of the megakaryoblastic subtype. All 8 AML patients who had analyzable metaphase cells revealed clonal chromosomal abnormalities in addition to trisomy 21. Three of these patients developed MDS prior to the onset of AML. Of the 5 patients who underwent chemotherapy, 3 remained in remission with a survival time of 29, 59, and 109 months, and the remaining 2 died as a consequence of chemotherapy toxicity. Among the 6 patients (38%) who developed transient myeloproliferative disorder, 2 were lost to follow-up, 2 died from DS-associated congenital heart abnormalities and 2 survived without any AML changes. The remaining 1 patient (6%) who developed ALL was still in his first remission although this patient suffered profound chemotherapy complications during treatment. CONCLUSIONS: This study found that AML is the most common hematologic neoplasm in Taiwanese children with DS, especially megakaryoblastic leukemia. This finding is comparable to the reported results from related studies in different countries. Long-term remission of AML in DS patients can be achieved with appropriate treatment.     

Apoptosis and apoptosis-related proteins (Fas, Fas ligand, Blc-2, p53) in lymphoid elements of human ovarian tumors

Different types of lymphocytes have different roles in tumor suppression. Thus, their expression of apoptosis-related proteins (ARP - Fas and Fas ligand, bcl-2, p53) in lymphocytes and their apoptosis were analyzed immunohistochemically in ovarian tumors of different grades. Ovaries without oncologic disorders had few lymphocytes, mainly T cells, and no ARP. Benign cysts presented features of weak immune reaction: small lymphoid infiltration and few lymphocytes. The ARP were present in 13.7% to 23.5% of the lymphocytes, and apoptosis was rare. In borderline tumors, expansion of lymphoid infiltrates and increased density of lymphocytes resulted in a tenfold rise in total lymphocytes, reflecting intensification of the immune response. Most lymphocytes were T cells (92%) predominated by CD8+ cells that were in direct contact with tumor epithelial cells. ARP species were found in 47% to 65% of the lymphocytes, and apoptosis in 2.2%. In carcinomas with ligh lymphoid infiltration, lymphocytes were 2.5 times more abundant, and the apoptotic index as well as the number of CD20+ and CD25+ lymphocytes rose sharply, whereas bcl-2 positive lymphocytes decreased to 8% of their number in borderline tumors. In carcinomas with low lymphoid infiltration, the total lymphocyte count decreased eightfold compared to carcinomas with high lymphoid infiltration, reflecting the deep subcompensation of the lymphoid system. Few p53-positive lymphocytes were found in the carcinomas. In conclusion, we found a positive correlation between apoptosis and the numbers of CD4+ or CD8+ lymphocytes in epithelial ovarian tumors. This correlation could reflect the antitumor activity of T cells. However, the high expression of ARP studied by immune cells at the vicinity of the tumor ARP reveals the lymphoid vulnerability to apoptosis, resulting in devastation of the lymphoid tissue, and consequently in tumor progression.     

Gains and losses of CD8, CD20 and CD56 expression in tumor stroma-infiltrating lymphocytes compared with tumor-associated lymphocytes from ascitic fluid and lymphocytes from tumor draining lymph nodes in serous papillary ovarian carcinoma patients

Serous papillary ovarian cancer (SPC) is a highly aggressive tumor. About two-thirds of women have advanced disease at the time of diagnosis. Although many women with disseminated disease respond at first to combinations of surgery and chemotherapy, nearly 90% of tumors recur and women die of disease. Update progress in our knowledge of tumor-associated antigens and insight into mechanisms involved in immune-mediated recognition of these antigens, have provided a strong starting point for using the immune system as a model for novel therapy. In this study we determined the immunological profile of tumor-infiltrating lymphocytes (TILs), tumor-associated lymphocytes (TALs) in ascitic fluids, and lymphocytes from tumor draining regional lymph nodes (LNs) in SPC patients by CD20 (L26), CD8, and CD56 immunostaining. We examined 14 cases of TILs, 15 cases of TALs and 19 cases of LNs. TILs were infiltrating tumor stroma. No significant difference was detected in TILs, TALs and LNs in the expression of the B-cell marker CD20. In contrast, CD8 (T-cytotoxic) and CD56 (natural killer cell, NK) markers were dominant in LNs and TALs, but not in TILs. We conclude that SPC tumor lymphocytic infiltrate demonstrates a deplete T cytotoxic (CD8+) and NK cell (CD56+) immunophenotypic profile. This might in part explain the poor clinical outcome of the disease.