CD8+淋巴细胞浸润对可手术乳腺癌预后的影响

目的 探讨CD8+淋巴细胞浸润与乳腺癌临床病理特征及预后的关系。方法 回顾性分析2000年1月至2008年12月中山大学肿瘤防治中心收治的681例可手术切除的乳腺癌患者的临床资料，用组织芯片免疫组化法检测乳腺癌原发灶中CD8+淋巴细胞浸润情况，分析其与乳腺癌临床病理特征及预后的关系。结果42.0%（286/681）的乳腺癌间质存在CD8+淋巴细胞高浸润。CD8+淋巴细胞浸润与乳腺癌患者的年龄、月经情况、肿瘤大小、淋巴结转移、病理分期、脉管癌栓、组织学分级、激素受体表达、HER-2表达有关（P＜0.05）。全组患者的5年无病生存率和5年生存率分别为79.2%和87.6%；其中CD8+淋巴细胞高浸润者与低浸润者的5年无病生存率分别为83.2% 和68.8%，5年生存率分别为89.5%和82.2%，差异均有统计学意义（P＜0.05）。Cox多因素分析显示，CD8+淋巴细胞浸润是影响患者无病生存和总生存的独立预后因素。结论 CD8+淋巴细胞浸润可作为预测可手术乳腺癌预后的一个指标。

The effect of infiltrating CD8+lymphocytes on prognosis of operable breast cancer

Objective To investigate the prognostic value and clinicopathological characteristics of tumor-infiltrating CD8＋lymphocytes in operable breast cancer. Methods Paraffin sections were retrospectively collected from 681 cases of operable breast cancer patients from January 2000 to December 2008 in Cancer Center of Sun Yat-sen Unversity. Immunohistochemical staining of tissue microarray were used to assess the density of tumor-infiltrating CD8＋ lymphocytes. The number of CD8＋ lymphocytes counted in tumor stroma, and the relationship with clinical outcome and clinicopathological characteristics was determined. Results The propor-tion of high infiltrating CD8＋ lymphocytes was 42. 0%（ 286/681） in interstitial tissues of breast cancer. The infiltrating CD8＋ lympho-cytes were related to age at diagnosis, menstruation, tumor size, lymph node metastasis, pathological stage, lymphovascular invasion, histological grade, hormone receptor status and HER-2 status（ P〈0. 05） . The 5-year disease-free survival rate and 5-year overall sur-vival rate in the whole patients were 79. 2% and 87. 6%, respectively. The 5-year disease-free survival rate of patients with high and low tumor-infiltrating CD8＋ lymphocytes were 83. 2% and 68. 8%, the 5-year overall survival rate were 89. 5% and 82. 2%. The high tumor-infiltrating CD8＋lymphocytes were associated with better survival（ P〈0. 05） . In multivariate analysis, the number of CD8＋lym-phocytes was an independent prognostic factor influencing disease-free survival and overall survival. Conclusion Infiltrating CD8＋lymphocytes may become a prognositic predictor for operable breast cancer.