肿瘤引流淋巴结中免疫活性细胞分布的原位分析

目的:观察人乳腺癌和胃癌局部引流淋巴结(LDLN)从无转移、微转移到晚期转移过程中,免疫组织学变化及免疫活性细胞(ICC)的分布特征。方法:采用传统的病理学方法,对22例乳腺癌LDLN(71个)和7例进展期胃癌LDLN(28个)进行组织形态学分类,并以抗穿孔素、抗颗粒酶B、抗CD8、抗CD56、抗CD68、抗S-100、抗CD134及抗CD25单克隆抗体(mAb)进行催化信号放大(Catalyzedsignalamplification,CSA)免疫组化染色,检测肿瘤LNDN中ICC的分布。结果:肿瘤LDLN中以副皮质区增生和窦组织细胞增生为主,细胞毒性T淋巴细胞(CTL)及树突状细胞(DC)的数量,从无转移、微转移到晚期转移过程中有逐渐减少的趋势。在无和微转移的淋巴结内,穿孔素 、颗粒酶B 及S100 DC的数量高于晚期转移淋巴结(P<0.05);而S100 DC不仅数量减少,而且其形态也有变化,呈多角形、星形,并有胞质突起,与周围淋巴细胞接触呈活化状态的DC变为椭圆形,少有胞质突起或呈短突起的静止状态的DC。CD134 细胞及CD25 细胞的数量在晚期转移淋巴结中明显高于无和微转移淋巴结(P<0.01)。ICC在无和微转移的前哨和非前哨淋巴结中的分布无统计学意义(P>0.05)。结论:肿瘤LDLN中ICC分布的变化,提示随着肿瘤的进展,其免疫微环境向抑制机体抗肿瘤免疫的方向偏移。

In situ analysis of distribution of immunocompetent cells in tumor''''s local draining lymph nodes

AIM: To observe the distribution of immunocompetent cells (ICCs) in tumor's local draining lymph nodes (LDLN) at different stages of disease including non-metastasis, micro-metastasis and late metastasis. METHODS: 71 LDLN from 22 breast cancer, 28 LDLN from 7 gastric carcinoma were analysed by using catalyzed signal amplification (CSA) immunohistochemical staining. Monoclonal antibodies (mAbs) to perforin, granzyme B, CD8, CD56, CD68, S-100, CD134 and CD25 were used to detect the amount and functional change of ICCs. RESULTS: Paracortical hyperplasia and sinus histocytosis was mainly observed in tumor's LDLN. As it was reported, the density of S100(+) dendritic cells (DCs) was decreased as the draining lymph nodes became tumor-containing from the status of tumor free (P<0.05), and the morphology of DCs turned to be inactivated. As the lymph nodes were invaded by tumors, the densities of CD134(+) lymphocytes and CD25(+) cells were significantly increased (P<0.01). Furthermore, there was a significant trend of decreasing in the number of activated cytotoxic T lymphocytes (granzyme B(+) cells) in LDLN as tumor progressed from non/micro-metastasis, early metastasis to advanced stage metastasis (P<0.01). There was no obvious difference in distribution of ICC between non/micro-metastasis sentinel lymph nodes and non-sentinel lymph nodes. CONCLUSION: The dynamic change of the ICCs in LDLN implied that immune response of tumor bearing host tends to be inhibited with the progress of tumors.