癌组织浸润的FoxP3十调节性T淋巴细胞与CD34表达及肝癌患者的预后相关

目的 探讨FoxP3+调节性T淋巴细胞(Tregs)在肝癌患者癌及癌旁组织中的表达及其对预后的影响.方法 收集55例肝癌患者术后癌及癌旁组织标本,免疫组织化学检测肝癌及相应癌旁组织Tregs数量及癌组织CD34的表达情况.Speaman相关分析法分析Tregs与患者各种临床病理因素的相关性;据中位数将Tregs绝对值分为高低组,Kaplan-Meier分析Tregs高低组的总生存期和无瘤生存期,Log rank检验差异性;Cox回归法分析临床病理因素对预后的影响.结果 肝癌组织中每高倍视野的Tregs数量为10.8 (4.4～ 19.4)个,与相应癌旁组织1.4 (0.6～3.2)个相比,明显升高(P＜0.01).癌组织Tregs与相应癌组织血管内皮细胞标志物CD34的表达呈正相关(r=0.279,P＜0.05);癌及癌旁组织Tregs与其他临床病理因素均无相关性(P＞ 0.05).癌组织高Tregs组患者中位生存时间(18.0个月)明显短于低Tregs组(25.0个月),术后5年累积生存率及无瘤生存率较低(P值均＜0.05).Cox回归分析显示癌组织中Tregs数量是影响肝癌预后的独立因素(累积生存率:风险比=3.310,95％可信区间为1.368 ～ 8.007,P＜0.0l ;无瘤生存率:风险比=2.666,95％可信区间为1.321 ～ 6.394,P＜0.01).结论癌组织中Tregs数量可作为评估手术治疗肝癌患者预后的免疫学指标,Tregs瘤内浸润与肿瘤组织血管生成相关.

Tumor-infiltrating FoxP3+ Tregs are associated with CD34 expression and prognosis of hepatocellular carcinoma

Objective To investigate the correlation between FoxP3+ regulatory T lymphocytes (Tregs) in hepatocellular carcinomas (HCCs) and peritumoral tissues with CD34 expression and patient prognosis.Methods Fifty-five sets of patient-matched tumors and peritumoral tissues were obtained during curative resection for HCC.In siru immunohistochemistry was used to assess and comparatively analyze Treg presence and CD34 expression in each specimen set.The relation between quantified Tregs values and various clinicopathologic factors were evaluated by the Spearman Rank Correlation test.Univariate (Log Rank test) and multivariate (Cox Regression model) analyses were used to determine the potential prognostic value of each factor.Results The average number of intratumoral Tregs was significantly higher than that in corresponding peritumoral tissues (10.8 (range: 4.4-19.4) vs.1.4 (0.6-3.2),respectively; P ＜ 0.01).The presence of intratumoral Tregs correlated with up-regulated CD34 expression (r =0.279,P ＜ 0.05).Increased number of intratumoral Tregs were significantly associated with decreased rates of overall survival (OS,P ＜0.05) and disease-free survival (DFS,P ＜ 0.05),and was identified as an independent prognostic factor (OS,hazard ratio (HR) =3.310,95％ confidence interval (CI): 1.368-8.007,P ＜ 0.01; DFS,HR =2.666,95％ CI:1.321-6.394,P ＜ 0.01).Conclusion Intratumoral infiltration by Tregs is a marker of poor prognosis in HCC.