胃癌肿瘤微环境中Th17细胞的分布及临床意义

目的：探讨随着肿瘤的进展胃癌肿瘤微环境中Th17细胞的分布及与患者预后、生存之间的关系。方法采用流式细胞术检测60例胃癌患者Th17细胞在不同时期的胃癌肿瘤微环境中的阳性表达率及分布。通过免疫组织化学染色验证120例胃癌患者Th17细胞的表达情况，并分析Th17细胞的表达与患者预后生存之间的关系。结果60例新鲜胃癌组织标本中，Th17细胞在肿瘤组织中的阳性表达率（10.3%±7.2%）高于癌旁正常胃组织（4.6%±2.5%），且组间差异具有统计学意义（P＜0.05）。而进展期胃癌组织中Th17细胞的阳性表达率（8.7%±6.8%）显著低于早期胃癌组织（12.4%±7.6%），且组间差异具有统计学意义（P＜0.05）。120例胃癌根治术后的组织标本中，Th17细胞高表达组5年生存率为58.7%，低表达组为40.4%，二者的差异有统计学意义（χ2=4.634，P=0.031）。结论胃癌肿瘤微环境中Th17细胞的表达与疾病的进展及患者的预后密切相关，可以作为预测胃癌患者术后生存的重要免疫指标。

The distribution and clinical significance of Th17 cells in the tumor microenvironment of gastric cancer

Objective To explore the distribution trends of Th17 cell in the tumor microenvironment as the gas-tric cancer progresses, and to investigate the correlation between Th17 cell and prognosis and survival of patients. Method In 60 cases of gastric cancer patients, the positive expression and distribution of Th17 cells in each tumor stage were detected by flowcytometry analysis (FACS). The expression of Th17 cells in 120 cases of gastric cancer patients were verified by immunohistochemistry (IHC). And the relationship between the expression of Th17 cells and the prognosis of gastric cancer patients were analyzed. Result Fresh tissue specimens of 60 gastric cancer pa-tients were collected and analyzed, the positive expression of Th17 cells in tumor tissue was higher than that in the normal gastric tissue (10.3%± 7.2%) vs (4.6%± 2.5%), with statistically significant difference (P<0.05). And the posi-tive expression of Th17 cells in tissue with advanced disease was significantly decreased compared to that in those with early-stage disease (8.7%± 6.8%) vs (12.4%± 7.6%), (P<0.05). In 120 post-gastrectomy tissue specimens, the 5-year survival rate was 58.7% in patients with high Th17 cell expression, and was 40.4% in those with low Th17 cell expression, and the difference was significant (χ2=4.634, P=0.031). Conclusion The high expression of Th17 cell in the tumor microenvironment was closely related with the progression of disease and the survival of the patients and may serve as an important and predictive immune indicator for survival.