胃腺癌癌巢和癌间质中巨噬细胞的分布及其与患者预后关系

目的了解胃腺癌组织中巨噬细胞（tumor associated macrophages，TAMs）浸润情况，探讨TAMs分布及其与预后的关系。方法采用免疫组织化学SP法，检测92例胃腺癌癌巢和癌间质中CD68^＋巨噬细胞数，结合随访资料分析TAMs与患者术后无复发生存率关系。结果胃腺癌间质及癌巢组织中均有大量TAMs浸润，且癌间质中TAMs表达高于癌巢（9．78个／HFP与4．00个／HFP，P=0．000）；Ⅰ＋Ⅱ期癌巢内TAMs高于Ⅲ＋Ⅳ期（4．73个／HFP与3．27个／HFP，P=0．001），Ⅰ＋Ⅱ期癌巢TAMs／癌间质TAMs比值高于Ⅲ＋Ⅳ期（0．58个／HFP与0．29个／HFP，P=0．004），而Ⅰ＋Ⅱ期癌间质TAMs低于Ⅲ＋Ⅳ期（8．85个／HFP与11．03个／HFP，P=0．000）。结论Cox风险比例回归模型显示，癌巢TAMs和癌巢／癌间质TAMs比值越大，患者无复发生存率越高，而癌间质TAMs越大患者无复发生存率越小。癌巢TAMs、癌间质TAMs及癌巢／癌间质TAMs比值可作为临床评估胃腺癌患者的预后指标。

The relationship between the distribution of tumor associated macrophages and the prognosis in the patients with gastric adenocarcinoma

Objective To investigate the effects of the distribution of tumor associated macrophages （TAMs） on prognosis in the patients with gastric adenocarcinoma. Methods The number of CD68^＋ cells in 92 Gastric cancer nest and stroma was counted simultaneously by streptavidin - perosidase （ SP ） , and its correlation with patient postoperation prognosis was analyzed. Its correlation with patient postoperation prognosis was analyzed. Results CD68^＋ macrophas were observed in both inside and around the cancer tissue. The mean TAMs count in cancer stroma（9.78/HFP）was higher than that in cancer nest（4. 00/HFP,P =0. 000）. The mean TAMs count in nest of stage I ＋ H cancer was significantly higher than that of stage Ⅲ ＋ Ⅳ cancer（4. 73/HFP vs. 3.27/ HFP,P =0. 001 ） ,the mean of the ratio of nest TAMs/stoma TAMs count of stage Ⅰ ＋ Ⅱ cancer was significantly higher than that of stage Ⅲ ＋ Ⅳ cancer（0. 58/HFP vs. 0. 29/HFP,P =0. 004） ,but mean TAMs in stroma count of stage Ⅰ ＋ Ⅱ cancer was significantly lower than that of stage Ⅲ ＋ Ⅳ cancer （ 8.85/HFP vs. 11.03/HFP, P = 0. 000）. Conclusion The higher the nest/stroma TAMs ratio is, the higher probability of the patients relapse - free survival will be. While the probability of the patients relapse - free survival gets lower as the number of TAMs in the cancer stroma gets higher. Distribution pattern of TAMs in cancer nest and cancer stroma could possibly be used to estimate the prognosis of patients with gastric adenocarcinoma.