食管癌诊断、分期和预后中多肿瘤抑制基因-1、分泌素-3A1的表达研究

目的:分析食管癌诊断、分期和预后中多肿瘤抑制基因-1(Multiple tumor suppressor gene-1,MTS-1)及分泌素-3A1(Secretoglobin-3A1,SCGB3A1)的表达及临床意义。方法:回顾性分析本院2014年10月至2017年10月期间临床确诊的79例食管癌患者的临床资料,通过对癌组织及癌旁组织进行免疫组化染色,检测组织中MTS-1及SCGB3A1的表达水平,并结合各组食管黏膜组织病理分期情况,分析MTS-1、SCGB3A1的表达与病理特征的相关性;并对79例患者进行为期2年的随访,观察预后情况。结果:所有患者癌组织中MTS-1、SCGB3A1表达率低于癌旁组织(P<0.05);肿瘤分期处于Ⅲ~Ⅳ期、伴随淋巴结转移、肿瘤低分化的食管癌患者MTS-1、SCGB3A1的表达更低;经Spearman相关性分析,患者MTS-1、SCGB3A1的表达与肿瘤分期、淋巴结转移程度呈负相关,而与肿瘤分化程度呈正相关(P<0.05);患者的年龄、性别、肿瘤大小与MTS-1、SCGB3A1表达无显著差异性(P>0.05);MTS-1低表达与SCGB3A1低表达患者预后2年生存率显著低于MTS-1高表达和SCGB3A1高表达患者(P<0.05)。结论:MTS-1、SCGB3A1在食管癌中呈低表达,且与其病理组织特征存在相关性,检测两者表达情况对临床上食管癌诊断、治疗以及病情评估具有一定指导意义。     

肝癌患者治疗前后T细胞亚群和sIL-2R水平的变化

采用间接免疫荧光法和双抗体夹心ELISA,检测原发性肝癌患者和健康人血T细胞亚群及可溶性白细胞介素-2受体(sIL-2R)水平,并比较患者手术治疗及栓塞治疗前后上两指标的变化.结果显示,原发性肝癌患者存在细胞免疫受抑,CD3~+、CD4~+细胞较正常低,CD8~+细胞和sIL-2R水平明显增高,且与肝癌临床分期相关,治疗后免疫受抑减轻,sIL-2R水平下降明显.显示检测T细胞及sIL-2R水平可为判断原发性肝癌病情提供有价值的参考资料.     

鼻咽癌18F-FMISO乏氧显像的临床相关性研究

目的 探讨18氟-米索硝唑(18F-FMISO)乏氧显像与鼻咽癌临床相关参数的相关性.方法 研究对象为2013年10月至2014年11月间经病理学确诊为鼻咽癌的患者39例,依治疗情况分为未化疗组和化疗组,未化疗组12例,化疗组(多西他赛联合奈达铂静脉化疗)27例;按照2009年鼻咽癌第7版UICC分期标准进行T分期, T1期3例,T2期14例,T3期13例,T4期9例.39例患者均进行18F-FMISO PET/CT显像;采用Mann-Whitney U检验比较鼻咽癌未化疗组和化疗组的原发灶放射性摄取视觉分析有无差异,以及两组间的SUVmax值有无差异;采用秩相关检验(Spearman相关)进行不同T分期肿瘤原发灶放射性摄取视觉分析,Kruskal-Wallis检验比较不同T分期肿瘤原发灶SUVmax值有无差异;以鼻咽癌大体肿瘤体积中位数26.6mm3为分界点,将原发灶分为两组,采用成组t检验比较两组间SUVmax的差异.结果 ①未化疗组和化疗组的原发灶视觉分析显示两组间差异无统计学意义(U=107.5,P=0.098),两组间SUVmax值差异无统计学意义(U=118,P=0.188).②不同T分期肿瘤原发灶放射性摄取视觉分析显示T分期与放射性摄取存在中等程度相关性( rs=0.513,P=0.001),不同T分期的SUVmax值差异有统计学意义(H=9.733,P=0.021).③体积≤26.6mm3组的SUVmax为1.41±0.21,体积>26.6 mm3组的SUVmax为2.05±0.86,两组间差异有统计学意义(t=-3.11,P=0.004).结论 鼻咽癌18F-FMISO乏氧显像原发灶SUVmax值与原发肿瘤大小及T分期之间存在相关性,与鼻咽癌化疗与否无明显统计学差异,提示肿瘤越大乏氧程度越明显,并对指导鼻咽癌生物靶区勾画具有一定的临床价值.     

常规全腹部增强CT结直肠癌术前评估的初步研究

目的通过病理对照常规平扫联合增强CT扫描评价结直肠癌肿瘤一般情况与临床T、N分期诊断效能指标,明确全腹部增强CT扫描的临床应用价值。方法回顾性分析2015年5月至10月我院经CT确诊的49例结直肠癌患者的临床资料,临床检查未发现结直肠癌远处转移。通过平扫加增强CT扫描并进行多平面重组评价结直肠癌肿瘤的一般情况(肿瘤位置、肿瘤尺寸、肿瘤大体病理类型)和结直肠癌T、N分期;将影像学分期与病理分期进行对照,分别计算T、N分期灵敏度、特异度、准确率;计算评价T、N分期正确率,进行一致性检验,P0.05为差异具有统计学意义。结果 CT检测肿瘤位置、大体病理类型与手术结果相比符合率为100%。CT测量肿瘤最大径与手术测量数据分别为(2.26±1.40)cm、(2.37±1.38)cm,数据呈高度相关(r=0.906,P=0.000)。影像学分期T分期正确率为65.3%,一致性较好(k=0.467,P=0.000)。影像学分期N分期正确率为63.3%,一致性较好(k=0.440,P=0.000)。结论增强CT扫描可以在结直肠癌术前评估中提供足够信息,具有重要临床应用价值。     

结直肠癌术后循环肿瘤细胞检测的临床意义

目的 探讨结直肠癌(CRC)患者术后外周血循环肿瘤细胞(CTCs)阳性率及其计数与临床病理特征、肿瘤复发转移及预后之间的关系及其临床意义。方法 回顾性分析2016年1月—2017年7月上海交通大学医学院附属第九人民医院首诊并经病理确诊的99例CRC患者的临床资料,其中男66例、女33例,年龄37~79岁。检测患者术后4~8周且辅助治疗前CTCs计数和血清癌胚抗原(CEA)水平,随访患者生存情况,比较患者不同临床病理学特征患者间CTCs表达及计数值的统计学差异,包括性别、年龄、原发灶部位、肿瘤分化程度、原发灶浸润深度(T分期)、区域淋巴结侵袭程度(N分期)、远处转移(M分期)、TNM总分期;观察患者生存情况;采用COX比例风险回归模型进行无进展生存期、总生存期的单因素和多因素分析。结果 99例CRC患者CTCs阳性率为60.6%(60/99),CTCs计数值为0~24(4.909±5.518)。患者的CTCs阳性率和CTCs计数值在T1+T2+T3期、N0期、M0期、Ⅰ~Ⅱ期、CEA＜5 ng/mL和中高分化组患者低于T4期、N1+N2期、M1期、Ⅲ~Ⅳ期、CEA≥5 ng/mL、低分化组患者,差异均有统计学意义(P值均＜0.05)。患者随访3~20个月,死亡22例(22/99,22.2%),其中CTCs阳性21例;疾病进展32例(32/99,32.3%),其中CTCs阳性29例。单因素分析显示:CTCs表达、N分期、M分期、肿瘤分期、和高CEA水平是无进展生存期的影响因素(P值均＜0.05);CTCs表达、N分期、M分期、肿瘤原发灶位于直肠、高CEA水平是总生存期的影响因素(P值均＜0.05)。CTCs和远处转移是CRC患者无进展生存期和总生存期的独立预后因素(HR= 5.418、2.254,95%可信区间:1.595~8.403、1.227~7.986,P值均＜0.05)。结论 在术后CRC患者中,CTCs表达与预后不良有关,对肿瘤复发转移评估具有一定的价值和临床意义。     

食管鳞状细胞癌中RNF113A的表达及临床病理意义

目的 探讨环指蛋白113A(ring finger protein 113A,RNF113A)在食管鳞状细胞癌(esophageal squamous cell carcinoma, ESCC)组织中的表达及临床病理意义。方法 采用免疫组化SP法检测100例ESCC组织及80例配对癌旁组织芯片中RNF113A的表达。结果 与癌旁正常组织相比，ESCC组织中RNF113A的表达上调，差异有统计学意义(P<0.05)。RNF113A表达与ESCC临床分期(P<0.009)、T分期(P=0.015)相关。Kaplan-Meier生存曲线提示，RNF113A表达与ESCC预后无关(P>0.05)。单因素分析结果显示，患者性别、临床分期、T分期、淋巴结转移及组织学类型影响ESCC患者的总生存期。多因素分析结果显示，肿瘤临床分期、淋巴结转移及组织学类型是ESCC预后的独立危险因素。结论 RNF113A在ESCC组织中高表达，且RNF113A表达程度越高，临床分期及T分期越晚；在RNF113A阳性ESCC中，男性、临床分期及T分期越晚、淋巴结转移阳性的患者术后生存率低，预后差。     

143例晚期喉癌患者的临床特征及生存分析

目的 总结143例晚期喉癌患者的临床特征,分析预后的影响因素。方法 回顾性分析2010年1月-2016年12月经中国人民解放军总医院治疗的143例晚期喉癌患者的临床资料。其中,男135例(94.4%),女8例(5.6%);年龄35~79岁,中位年龄58岁。依据患者治疗方案不同分为2组:手术联合术后放化疗组106例和非手术综合治疗组37例。收集患者基本临床情况、治疗、随访及生存情况;生存率及单因素生存分析采用Kaplan-Meier法和log-rank检验,多因素生存分析采用Cox比例风险回归模型。结果 143例晚期喉癌患者的5年总体生存率为67.9%。单因素分析显示,影响晚期喉癌患者预后的临床因素有年龄、临床分期、T分期及肿瘤分化程度等(P值均<0.05);Cox模型多因素分析显示,患者年龄、临床分期、肿瘤分化程度及治疗方式是影响预后的独立危险因素(P值均<0.05)。T₄期、临床Ⅳ期患者采用手术联合术后放化疗5年生存率分别为62.2%和59.5%,明显好于非手术综合治疗的18.2%和41.4%,差异均有统计学意义(P值均<0.05)。结论 晚期喉癌患者预后相对较差,影响患者预后的因素包括患者年龄、临床分期、肿瘤分化程度及治疗方式等。对于临床Ⅳ期、尤其是T₄期患者,采取手术联合术后放化疗可以获得相对较好的预后。     

血沉在溃疡性结肠炎分期及治疗中的价值

目的通过观察溃疡性结肠炎患者的血沉变化,评价血沉在活动性溃疡性结肠炎病情分期及治疗中的应用价值。方法采集72例活动性溃疡性结肠炎患者的血清,检测治疗前后血清中血沉变化水平,评估其在溃疡性结肠炎患者病情分期及临床疗效中的价值。结果活动性溃疡性结肠炎病情越重,血沉水平越高。活动性溃疡性结肠炎患者经过使用药物美沙拉秦和糖皮质激素有效治疗后,大多可以控制病情,检测血沉水平明显下降(P<0.05)。结论血沉可以作为一种评价和判断活动性UC患者严重程度及疗效的有价值指标。     

多种肿瘤标志物在结直肠癌患者术后腹腔引流液中的表达

目的:分析结直肠癌患者术后腹腔镜引流液中多种肿瘤标志物的表达水平及其与疾病的相关性.方法:抽选于江南大学附属医院2019年1月至12月接受手术治疗的76例结直肠癌患者,根据患者癌症分期情况将其分为I组(T1和T2期患者)和II组(T3和T4期患者),比较两组患者肿瘤标志物的检测结果,分析结直肠癌患者术前、术后有无淋巴转...     

头颈肿瘤浸润γδT细胞的数量及表型与临床分期相关

目的研究头颈肿瘤中浸润的Foxp3+γδT细胞的数量与头颈肿瘤临床分期的关系。方法 用组织研磨法分离患者肿瘤浸润淋巴细胞(TILs),用密度梯度离心法分离患者外周血单个核细胞(PBMCs);用固相化anti-pan-TCRγδ单克隆抗体对TIL和PBMC进行2～4周的体外扩增,免疫荧光染色和流式细胞仪测定扩增前后的细胞;对头颈肿瘤组织芯片进行免疫组织化学染色。结果 15例头颈肿瘤组织标本TIL中γδT占CD3+T细胞的0.37%～12.35%,其中0.13%～34.38%为Foxp3+γδT。扩增后TIL中γδT占CD3+T细胞的20.38%～82.87%,且以Vδ1亚型为主。肿瘤组织芯片按照肿瘤TNM分期中的T分期分为4组,Foxp3+γδT细胞的比例随肿瘤分期的提高而增加。结论 现有证据证明了头颈肿瘤组织中存在Foxp3+γδT细胞的浸润,并提示肿瘤组织中调节表型T细胞的数量可能与头颈肿瘤的预后相关。     

Aktuelle TNM/FIGO-Stadieneinteilung f��r das Zervix- und Endometriumkarzinom sowie maligne M��ller-Mischtumoren

Numerous recent studies of endometrial and cervical carcinomas as well as malignant mixed Müllerian tumors (MMMT) of the uterus have made a revision of the FIGO/TNM classification necessary, effective as of January 1st, 2010. There will be a new subclassification of carcinoma of the uterine cervix with proximal vaginal infiltration, using the same cut-off for the tumor extension as used for stage FIGOIB/T1b (??/>4?cm), resulting in stage FIGO IIA1/T2a1 and FIGO IIA2/T2a2. In endometrial carcinoma, the previous FIGO IA/pT1a and FIGO IB/pT1b will be merged to FIGO IA/pT1a. The former category FIGO IC/T1c will be changed into FIGO IB/T1b. The category FIGO IC/pT1c will not longer been used. Additionally, there will be no separate classification for the involvement of the endocervical glands by endometrial carcinoma. This feature will be incorporated in stage FIGO I/T1 disease. The new category FIGO II/T2 will be defined as endocervical stromal involvement. There will be a new category, termed T3c/IIIC, which includes regional lymph node involvement. Stage T3c1/IIIC1 will be defined as pelvic lymph node involvement and stage T3c2/IIIC2 para-aortal lymph node involvement with or without pelvic lymph node disease. In the TNM system, regional lymph node involvement can alternatively be classified as N1. The MMMT will be staged like endometrial carcinoma.     

Gross tumor size using the AJCC 8th ed. T staging criteria does not provide prognostic stratification for neoadjuvant treated pancreatic ductal adenocarcinoma

The 8th edition AJCC T stage criteria for pancreatic ductal adenocarcinoma (PDAC) are now size based. These criteria provide better prognostic stratification in patients without neoadjuvant therapy. Our aim was to determine if gross tumor size is prognostically significant using the 8th ed. staging criteria for neoadjuvant treated PDAC. The study included 289 patients who underwent resection for PDAC following neoadjuvant therapy. By AJCC 7th ed., there were 12 (4.2%) ypT0, 32 (11.1%) ypT1, 64 (22.1%) ypT2, and 181 (62.6%) ypT3 patients. By AJCC 8th ed., there were 12 (4.2%) ypT0, 74 (25.6%) ypT1 (6 ypT1a, 1 ypT1b, 67 ypT1c), 161 (55.7%) ypT2, and 42 (14.5%) ypT3 patients. 182 patients had negative lymph nodes and 107 had positive lymph nodes. 77 patients were ypN1 and 30 were ypN2 by 8th ed. criteria. 7th ed. T stage significantly correlated with OS (p = 0.048), while 8th ed. T stage did not correlate with OS (p = 0.13). In ypN0 patients, neither the 7th ed. or 8th ed. T stages significantly correlated with patient OS (p = 0.065 and 0.26, respectively). Higher 7th ed. T stage correlated with lymph node status (p ≤ 0.001) more strongly than 8th ed. T stage (p = 0.04). 7th ed. and 8th ed. N stage correlated with OS (p = 0.004 and p = 0.0002, respectively). By 8th ed. AJCC staging criteria, gross tumor size does not provide good prognostic stratification in neoadjuvant therapy PDAC. Mapped grossing techniques combining gross and microscopic examination to determine tumor size may provide more accurate staging of neoadjuvant treated tumors.     

Prognostic values of stromal proportion and PCNA, Ki-67, and p53 proteins in patients with resected adenocarcinoma of the lung.

Data from 64 patients who underwent surgical resection of lung adenocarcinomas were studied to identify clinicopathologic markers that might provide prognostic information on the clinical behavior of this neoplasia Patient staging was performed in accordance with the tumor-node-metastasis system as follows: Stage I (n = 29), Stage II (n = 11), Stage IIIA (n = 21), and Stage IIIB (n = 3). Overall follow-up time corresponded to the follow-up time for patients who were alive and to the survival time for patients who had died, all of them expressed in months. Data included age, staging, histologic type, morphometric assessment of histologic features related to tumor (stroma and vascularization), and immunohistochemical detection of proliferation cell markers (Ki-67 protein and proliferating cell nuclear antigen) and p53 protein. The morphometric assessment was made by the point-counting procedure. Data analysis included Life Tables for Survival and Cox Regression models. Overall follow-up analysis showed that significant univariate predictors (P < .05) were T stage; N stage; tumor stromal proportion; and immunohistochemical indexes of proliferating cell nuclear antigen, Ki-67, and p53 proteins. Variables that presented independent predictive value for overall follow-up with the multivariate model (P < .05) were sex, T stage, N stage, tumor stromal proportion, and immunohistochemical detection of p53 protein. We conclude that tumor stromal proportion and immunohistochemical detection of p53 protein, controlled for sex, T stage, and N stage, may be of critical value in the evaluation of recurrence of lung adenocarcinoma, serving as indicators for a more accurate prognosis.     

负性共刺激分子B7-H4在结直肠癌及其微环境中的表达及临床意义

负性共刺激分子B7-H4是新近发现的B7家族的新成员。为了检测人结直肠癌组织中肿瘤细胞及肿瘤浸润淋巴细胞(tumor-infiltrating lymphocyte,TIL)上B7-H4的表达以及分析巨噬细胞、T淋巴细胞及其亚群的浸润,进而探讨其相关临床意义,本课题采用免疫组化SP法检测98例人结直肠癌组织中肿瘤细胞及浸润淋巴细胞上B7-H4的表达以及巨噬细胞、T细胞及其亚群的浸润,统计学分析B7-H4的表达与患者临床病理参数、预后、肿瘤相关巨噬细胞(tumor-associated mac-rophage,TAM)以及CD3+T细胞、CD8+T细胞浸润程度的相关性。结果显示,结直肠癌组织中高表达B7-H4分子,而正常组织中基本不表达,并且在肿瘤细胞及浸润淋巴细胞中均检测到B7-H4的表达。统计学分析表明,浸润淋巴细胞中B7-H4的表达与患者年龄、有无淋巴结转移、是否为粘液腺癌有关(P<0.05),与患者总体生存率呈负相关(P<0.05),且B7-H4高表达组织较B7-H4低表达组织CD3+T细胞高度浸润例数显著增加(P<0.05);肠癌细胞中B7-H4的表达与患者肿瘤分期、淋巴结转移、有无远处转移以及Dukes分期有关(P<0.05)。综上所述,人结直肠癌患者的肠癌细胞及浸润淋巴细胞较正常细胞均异常表达B7-H4分子,CD3+T细胞的浸润程度与浸润淋巴细胞中B7-H4的表达呈显著相关而与肿瘤细胞上B7-H4的表达无关,而肿瘤细胞表达B7-H4与肿瘤分期、淋巴结转移、有无远处转移以及Dukes分期有关。上述结果提示肿瘤细胞表达B7-H4与浸润淋巴细胞表达B7-H4可能分别以不同机制参与了肿瘤的发生和进展,进一步分析肿瘤组织中B7-H4在不同细胞表达的生物学和临床意义具有重要的价值。     

Immunophenotypic markers in renal cell carcinoma.

We studied immunophenotypic and tumor cell markers in renal cell carcinoma (RCC) to determine if there are patterns of expression which may correlate with biologic behavior and response to therapy. Fourteen RCCs from 13 patients were stained by the immunoperoxidase technique using primary antibodies to Leu 4, Leu 14, Leu 2a, Leu 3a and b, lysozyme, dendritic reticulum cell (DRC), S-100, HLA-DR, epithelial membrane antigen (EMA) and beta-2-microglobulin (B2-MG). Staining was correlated with tumor stage, nuclear grade, histologic patterns, degree of cellular infiltrate, and clinical followup. Four RCCs were stage T1, four T2, five T3, and one T4. Most tumors were clear or granular cell type, with a solid or tubular growth pattern. The number of infiltrating lymphocytes and monocytes correlated with tumor grade and stage. Tumor-infiltrating lymphocytes (TILs) were predominantly Leu 3-positive (T-helper phenotype). B-cell markers were negative. Dendritic cells were rare. HLA-DR was present on endothelial cells in 11 tumors and on tumor cells in ten. HLA-DR expression increased with tumor grade. Tumor cells expressed EMA in 12 cases; B2-MG in four cases. Two patients, stages 3 and 4, died at 2 and 6 mo. Conclusions: (a) T-helper cells and monocytes infiltrate RCCs. Their numbers increase with tumor grade and stage. (b) HLA-DR expression by tumor cells tends to correlate with increasing stage and grade. (c) Dendritic cells are infrequent in RCCs.     

Expression of E-cadherin and alpha-, beta-, gamma-catenins in patients with bladder cancer: identification of gamma-catenin as a new prognostic marker of neoplastic progression in T1 superficial urothelial tumors

Loss of intercellular adhesion facilitates tumor invasion. To clarify the relation between altered expression of cell adhesion molecules and progression of T1 superficial bladder tumors, 101 cases (71 T1 tumors, 30 T2/T3 tumors) were examined immunohistochemically for E-cadherin and alpha-, beta-, and gamma-catenins. A highly significant correlation was observed between the decreased expression of all molecules and increased TNM stage (P < .001). Univariate analysis, performed in cases of T1 tumors, revealed association of abnormal E-cadherin with beta-catenin diminution. Survival curves were established with the Kaplan-Meier method and analyzed according to clinical and histopathologic parameters using the log-rank test. Cox multivariate analysis revealed only gamma-catenin as an independent predictor of progression-free survival in patients with stage T1 bladder urothelial tumors. The characterization of T1 tumors that will progress could lead to the identification of patients who might benefit from surgery to avoid vesical muscle invasion and, consequently, metastasis.     

Prognostic factors in survival of patients with stage Ta and T1 bladder urothelial tumors: the role of G1-S modulators (p53, p21Waf1, p27Kip1, cyclin D1, and cyclin D3), proliferation index, and clinicopathologic parameters

We studied 159 cases of superficial (stage Ta or T1) bladder tumors to determine the significance on survival of a subset of regulators of transition from G1 to S phase of the cell cycle (p53, p21Waf1, p27Kip1, cyclin D1, cyclin D3) and tumor proliferation (Ki-67 [MIB-1]). Clinical findings (patient age, sex, tumor size, grade, stage [Ta or T1]) were included in the analysis. Univariate analysis revealed association of tumor size (P = .0353), grade in stage Ta tumors (P = .0074), cyclin D1 expression (P = .0182), and Ki-67 index (P = .0033) with disease-free survival and of tumor size (P = .0005), stage (P = .0494), cyclin D3 expression (P = .0105), and Ki-67 index (P = .0272) with overall survival. Cox multivariate analysis revealed cyclin D1 expression and high proliferation index (disease-free) and tumor size, cyclin D3 expression, and high proliferation index (overall survival) as independent predictors. Results suggest that alterations of the progression from the G1 to S phase of the cell cycle are common in papillary urothelial bladder tumors. High tumor proliferation, expression of cyclins D1 and D3, and tumor size at diagnosis might be relevant predictors of survival in patients with stage Ta and T1 bladder urothelial tumors.     

CD4＋CD25＋调节性T细胞在胃癌患者外周血分布的临床意义和作用机制

目的：探讨CD4＋CD25＋调节性T细胞在胃癌患者外周血分布的临床意义及其作用机制。方法流式细胞术分析不同TNM分期的胃癌患者和健康者外周血CD4＋CD25＋调节性T细胞的比例。免疫磁珠分离胃癌患者和健康者外周血CD4＋CD25＋调节性T细胞,将CD4＋CD25＋调节性T细胞与淋巴细胞体外共培养, CCK8方法检测CD4＋CD25＋调节性T细胞对淋巴细胞的增殖能力的影响。 RT?PCR检测CD4＋CD25＋调节性T细胞特异性转录因子Foxp3 mRNA的表达水平。结果胃癌患者外周血CD4＋CD25＋调节性T细胞的比例明显高于健康者,差异具有统计学意义（P＜0．05）。其中Ⅲ期和Ⅳ期胃癌患者外周血调节性T细胞的比例均明显高于Ⅰ?Ⅱ期胃癌患者,差异具有统计学意义（ P ＜0．05）。与健康者相比,胃癌患者 CD4＋CD25＋调节性T细胞能明显抑制淋巴细胞增殖,其差异具有统计学意义（ P＜0．05）,而且Ⅲ期和Ⅳ期胃癌患者CD4＋CD25＋调节性T细胞抑制淋巴细胞增殖的能力明显强于Ⅰ?Ⅱ期胃癌患者,其差异具有统计学意义（P＜0．05）。进一步分析显示胃癌患者CD4＋CD25＋调节性T细胞Foxp3 mRNA的表达水平均明显高于健康者,差异具有统计学意义（P＜0．05）。其中Ⅲ期和Ⅳ期胃癌患者Foxp3 mRNA的表达水平明显高于Ⅰ?Ⅱ期胃癌患者,其差异具有统计学意义（P＜0．05）。结论调节性T细胞可能通过增强Foxp3 mRNA表达发挥免疫抑制作用,促进胃癌的发生发展。通过监测外周血调节性T细胞有利于评估胃癌患者免疫功能和病情进展。     

The spatial landscape of T cells in the microenvironment of stage III lung adenocarcinoma

This study aimed to provide more information for prognostic stratification for patients through an analysis of the T-cell spatial landscape. It involved analyzing stained tissue sections of 80 patients with stage III lung adenocarcinoma (LUAD) using multiplex immunofluorescence and exploring the spatial landscape of T cells and their relationship with prognosis in the center of the tumor (CT) and invasive margin (IM). In this study, multivariate regression suggested that the relative clustering of CT CD4⁺ conventional T cell (Tconv) to inducible Treg (iTreg), natural regulatory T cell (nTreg) to Tconv, terminal CD8⁺ T cell (tCD8) to helper T cell (Th), and IM Treg to tCD8 and the relative dispersion of CT nTreg to iTreg, IM nTreg to nTreg were independent risk factors for DFS. Finally, we constructed a spatial immunological score named the G_T score, which had stronger prognostic correlation than IMMUNOSCORE® based on CD3/CD8 cell densities. The spatial layout of T cells in the tumor microenvironment and the proposed G_T score can reflect the prognosis of patients with stage III LUAD more effectively than T-cell density. The exploration of the T-cell spatial landscape may suggest potential cell–cell interactions and therapeutic targets and better guide clinical decision-making. © 2024 The Pathological Society of Great Britain and Ireland.