网/腹膜乳斑的巨噬细胞表型与结直肠癌分期的关系

【摘要】 目的 探讨不同分期结直肠癌网/腹膜乳斑巨噬细胞的表型及作用。 方法 收集番禺中心医院普外科2011年1月至2012年12月不同分期结直肠癌患者网/腹膜乳斑标本60例及正常人网/腹膜乳斑标本10例。分离培养巨噬细胞,通过CD68免疫荧光染色、流式细胞术(FCM)鉴定网/腹膜乳斑巨噬细胞表型,酶联免疫吸附测定(ELISA)检测网/腹膜乳斑巨噬细胞IL-10、IL-12的分泌情况。结果 对照组、T1-3期组网/腹膜乳斑M1型巨噬细胞数量明显高于T4期组(P均<0.01);T4期组M2型巨噬细胞数量则明显高于对照组及T1-3期组(P均<0.01)。网/腹膜M1型巨噬细胞与结直肠癌T分期呈负相关(P<0.01),而M2型巨噬细胞的表达则与结直肠癌T分期呈正相关(P<0.01)。各组不同时点网/腹膜乳斑巨噬细胞IL-10、IL-12的分泌有显著差异:对照组及T1-3期组IL-10均低于T4期组,而L-12则均高于T4期组(P均<0.05);乳斑巨噬细胞IL-12的分泌与结直肠癌T分期呈负相关(P均<0.01),而IL-10的分泌则与结直肠癌T分期呈正相关(P<0.01)。结直肠癌网/腹膜乳斑巨噬细胞表型与临床分期特别是浆膜是否受到肿瘤侵犯、淋巴结有否转移有关(P<0.05),而与肿瘤直径及分化程度无关(P>0.05)。 结论 网/腹膜乳斑巨噬细胞表型表达主要受浆膜是否受到肿瘤侵犯和淋巴结有否转移两方面因素影响;T1-3期结直肠癌患者,网/腹膜乳斑巨噬细胞以M1型为主,对肿瘤细胞起捕获和杀灭作用;T4期结直肠癌患者,网/腹膜乳斑巨噬细胞以M2型为主,对肿瘤生长起促进作用。

The relationship between the phenotypes of macrophages in omental/peritoneal milky spots and the clinical stages of colorectal carcinomas

Objective To investigate the relationship between the phenotypes of macrophages in omental/peritoneal milky spots and the clinical stages of coloreetal carcinomas. Methods Omental and peritoneal specimens of colorectal carcinomas with different stages （60 cases） and normal person （10 cases）were collected in the central hospital of Panyu district from January 2011 to December 2012. After the macrophages had been isolated and purified,the phenotypes of macrophages in omental/peritoneal milky spots were identified and determined by immunofluorescence staining and Flow Cytometry （FCM）. And the secretion of IL-10 and IL-12 in different time points were detected by Enzyme linked immunosorbent assay （ELISA）. Results The number of M1 type macrophages in control and T1-3 group was larger than that in T4 group （P all〈0.01）. The number of M2 type macrophages in T4 group was larger than that in control and T1-3 group （P all〈0.01 ）. The number of M1 type maerophages was negative correlated with T stages of eolorectal carcinomas （P〈0.01）. But the number of M2 type macrophages was positive correlated with T stages of colorectal carcinomas （P〈 0.01）. There was significant differences in the secretion of IL-10 and IL-12 in different time points among three groups： the IL-10 in control and T1-3 group were lower than T4 group （P all〈0.05） ;the IL-12 in T4 group were lower than control and T1-3 group （P all〈0.05）. The secretion of IL-12 in macrophages in omental/peritoneal milky spots was negative correlated with T stages of eolorectal carcinomas （P〈0.01）. On the contrary, the secretion of IL-10 was positive correlated with T stages （P〈0.01）. There was a close correlation between the phenotypes of macrophages in milky spots in the omentum/peritoneum and clinical staging in patients of colorectal carcinomas, especially serosa tumor invasion and tumor lymphnode metastasis （P〈0.05）. Conclusion The phenotypes of macrophages in milky spots in the omentum/peritoneum is influenced by serosa tumor invasion and tumor lymphnode metastasis; Milky spots mainly express M1 type macrophages in patient with eoloreetal carcinomas in stage T1-3, it can capture and kill tumor cell; Milky spots mainly express M2 type maerophages in the T4 stages, and promote role for the growth of tumor.