组织CD68+巨噬细胞与CD57+NK细胞对原发性食管癌生存状况的影响

Effects CD68+ macrophages and CD57+ natural killer cells on survival condition of patients with primary esophageal cancer

摘要:

目的：探究组织CD57+自然杀伤（natural killer，NK）细胞与CD68+巨噬细胞对原发性食管癌生存状况的影响。方法：回顾性分析2013年6月至2015年6月期间我院收治的96例原发性食管癌患者的临床资料。通过免疫组织化学染色法对患者CD57+NK细胞与CD68+巨噬细胞的浸润水平进行评估，分析96例患者CD57+NK细胞与CD68+巨噬细胞浸润情况、细胞浸润水平与病理特征的关系、CD57+NK细胞与CD68+巨噬细胞与TNM分期的关系、细胞浸润对原发性食管癌患者生存状况的影响。结果：原发性食管癌患者上皮组织中CD57+NK细胞高度浸润程度为64.58％，CD68+巨噬细胞为51.04％。原发性食管癌患者上皮组织中CD57+NK细胞与CD68+巨噬细胞浸润水平与患者的年龄、性别、肿瘤大小、N分期、T分期、TNM分期均无显著相关性（P＞0.05）。原发性食管癌患者CD57+NK细胞、CD68+巨噬细胞在TNM分期Ⅰ-Ⅱ期与Ⅲ-Ⅳ期上的比较，癌旁CD57+NK细胞与CD68+巨噬细胞计数无统计学差异（P>0.05）。Ⅰ-Ⅱ期患者癌中CD57+NK细胞与CD68+巨噬细胞计数分别为（8.35±5.36）个/HP和（39.43±14.05）个/HP，均明显高于Ⅲ-Ⅳ期患者[（5.34±4.55）个/HP、（20.18±9.62）个/HP]，差异具有统计学意义（P<0.05）。采用 Cox模型（Forward：LR，引入α=0.05，剔除α=0.10）分析细胞浸润对原发性食管癌患者生存状况的影响。原发性食管癌患者肿瘤组织中CD57+NK细胞低浸润水平具有较高的死亡风险（P=0.046，RR=0.794，95％CI=0.633~0.996）；原发性食管癌患者肿瘤组织中CD68+巨噬细胞高浸润水平具有较高的死亡风险（P=0.000，RR=1.925，95％CI=1.364~2.717）。结论：CD57+NK细胞与CD68+巨噬细胞浸润水平能够反映机体免疫状态，CD57+NK细胞与CD68+巨噬细胞浸润水平检测在判断原发性食管癌患者的生存状况方面具有一定的临床价值。

Abstract:

Objective：To explore the impact of CD57+ natural killer（NK） cells and macrophages CD68+ on the survival conditions of patients with primary esophageal cancer. Methods：Clinical data of 96cases of primary esophageal cancer from June 2013 to June 2015 in our hospital were retrospectively analyzed. Infiltration levels of CD57+ NK cells and macrophages CD68+ were evaluated by immunohistochemical staining method. The relationship between cells infiltrating level and the pathological characteristics was ana－lyzed. CD5+ NK and CD68+ macrophages relations with TNM staging，and the effect of cell infiltration on the survival conditions of primary esophageal cancer patients were analyzed. Results：The degree of infiltration of CD57+ NK cells in the epithelium of patients with primary esophageal carcinomawas 64.58% and that of CD68+ macrophages was 51.04%. There was no significant correlation be－tween the level of CD57+ NK cells and CD68+ macrophages in the epithelium of patients with primary esophageal carcinoma and the age，sex，tumor size，N stage，T stage and TNM staging（P>0.05）. There was no significant difference in CD57+ NK cells and CD68+ macrophage counts between CD57+ NK cells and CD68+ macrophages in primary esophageal cancer patients（P>0.05）. CD57+ NK cells and CD68+ macrophage counts were （8.35±5.36）/HP and （39.43±14.05）/HP respectively at stageⅠ-Ⅱ，significantly higher than those at stage Ⅲ-Ⅳ[（5.34±4.55）/HP，（20.18±9.62）/HP]（P<0.05）. The effect of cell infiltration on the survival of patients with primary esophageal cancer was analyzed by Cox model （Forward：LR，introducing α=0.05，excluding α=0.10）. The low level of death of CD57+ NK cells in tumor tissue of patients with primary esophageal cancer had a high risk of death（P=0.046，RR=0.794，95%CI=0.633 to 0.996）. The high level of death of CD68+ macrophages in tumor tissue of patients with primary esophageal cancer had a high risk of death（P=0.000，RR=1.925，95%CI=1.364 to 2.717）. Conclusion：CD57+ NK cells and CD68+ macrophages infiltration level can reflect the body’s immune status. CD57+ NK cells and CD68+ macrophage infiltration level has certain clinical value in determining the survival of patients with primary esophageal cancer.