肿瘤浸润淋巴细胞在浆液性卵巢癌的临床病理分析

目的:探讨浆液性卵巢癌中肿瘤浸润性淋巴细胞(TIL)的临床病理和免疫组织化学特征及临床意义。方法:利用免疫组织化学法对68例浆液性卵巢癌中TIL进行组织病理学观察,并分析其与各临床病理因素的关系。结果:68例浆液性卵巢癌中有大量TIL浸润者(≥50 TIL/100肿瘤细胞)43例,占63.24%。有无大量TIL浸润在不同肿瘤细胞分化程度、临床分期、CA125水平中差异有统计学意义(P0.05)。浆液性卵巢癌组织癌巢内CD3~+、CD4~+、CD8~+细胞数显著低于间质内(P0.05);癌巢内CD4~+/CD8~+比值也明显低于间质内(P0.05)。Ⅲ期、低分化组癌巢内及间质内CD4+/CD8~+比值分别低于Ⅰ~Ⅱ期与高-中分化组(P0.05)。癌巢内CD8+/FoxP3~+Treg比值显著低于间质(P0.05);Ⅲ期、低分化组肿瘤癌巢内的CD8+/FoxP3+Treg比值显著降低(P0.05)。Ⅲ期、低分化组患者癌巢中GzmB表达分别低于Ⅰ~Ⅱ期和高-中分化组(P0.05)。结论:有无大量TIL浸润与浆液性卵巢癌肿瘤分化程度、临床分期、CA_(125)水平有关。

Clinicopathological Characteristics of Tumor Infiltrating Lymphocytes in Ovarian Serous Adenocarcinoma

Objective:To investigate the clinicopathological characteristics and immunohistochemical features of tumor-infiltrating lymphocyte(TIL) in ovarian serous adenocarcinoma,and their clinical value.Methods:The immunohistochemistry was used to observe 68 ovarian serous adenocarcinomacases'immunohistochemical features,and their correlations with clinicopathological characteristics were analyzed.Results:There were 43 cases with a large amount of TIL infiltrating in the 68 cases of serous adenocarcinoma,account for 63.24％.There were significant differences on the with or without a large amount of TIL infiltrating among the different tumor grade,different clinical stage,and different CA125 level (P ＜ 0.05).The numbers of CD3 +,CD4 + and CD8 + TIL in the cancer nest were significantly less than those in the stroma,with significantly statistical difference (P ＜ 0.05),Meanwhile the ratio of CD4 +/CD8 + in the cancer nest was significantly less than that in the stroma(P＜0.05).The ratio of CD4 +/CD8 + in the cancer nest and stroma at stage Ⅲ and with poor differentiation was significantly lower than in those at stage Ⅰ-Ⅱ and with good differentiation(P＜0.05).Meanwhile the ratio of CD8 +/FoxP3 + Treg in the cancer nest was less than that in the stroma(P＜0.05).The ratio of CD8 +/FoxP3 + Treg in the cancer nest at stage Ⅲ and with poor differentiation tumor was significantly lower than in those at stage Ⅰ-Ⅱ and with good differentiation(P＜0.05).The expression of GzmB in the cancer nest at stage Ⅲ and with poor differentiation tumor was significantly lower than that in the cancer nest at stage Ⅰ-Ⅱ and with good differentiation tumor(P＜0.05).Conclusions:With or without a large amount of TIL is related to tumor grade,clinical stage,and CA125 level inovarian serous adenocarcinoma.The numbers of TIL in ovarian serous adenocarcinoma increase considerably,but mainly in the stroma,and which may be related to several factors such as tumor cell differentiation and clinical stage.