乳腺癌淋巴细胞亚群与不同分子亚型及临床病理特征的意义研究(1)
[摘要] 目的 检测不同分子亚型乳腺癌患者外周血淋巴细胞亚群的变化，探讨其与临床病理特征的关系。 方法 选取广西医科大学附属肿瘤医院2013年1～12月就诊收治的206例女性乳腺病患者，随机将其分为166例乳腺癌组(观察组，n=166)及40例正常健康组(对照组，n=40)，观察组采用免疫组化Envision二步法检测雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)、Ki-67的蛋白表达情况并进行分子分型，后采用流式细胞仪法测定两组的外周血各淋巴细胞亚群CD3+、CD4+、CD8+、CD16+CD56+、CD19+的活性，结合临床和病理特征资料进行比较分析。 结果 在Luminal A型、Luminal B型及HER-2过表达型中，CD3+活性、CD4+/CD8+比值与正常健康组比较均下降，差异有统计学意义(P<0.05)；在4种分子亚型中，CD4+、CD19+活性与正常健康组比较均下降，差异有统计学意义(P<0.05)；三阴性型的NK(CD16+CD56+)活性与正常健康组比较下降，差异有统计学意义(P<0.05)。组织学Ⅱ级的CD4+ 活性明显低于组织学Ⅰ级，两者比较差异有统计学意义(34.35±9.03 vs 38.12±8.75，P<0.05)；组织学Ⅲ级的NK(CD16+CD56+)活性明显低于组织学Ⅱ级，两者比较差异有统计学意义(13.92±6.34 vs 16.15±7.98，P<0.05)。有淋巴结转移的患者CD4+活性及CD4+/CD8+比值均低于淋巴结无转移的患者，两者比较差异有统计学意义(P<0.05)。 结论 外周血淋巴细胞亚群的测定对于了解不同分子亚型的乳腺癌患者机体免疫功能的状态有一定的意义，有助于病情观察、疗效监测、预后判断。
[关键词] 乳腺癌；淋巴细胞亚群；分子分型；临床病理特征
[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721(2016)04(b)-0008-04
[Abstract] Objective To detect the changes of peripheral blood lymphocyte subsets in patients with different subtypes of breast cancer，and explore the relationship between different subtypes of breast cancer and their clinical pathological characteristics. Methods A total of 206 patients with women breast disease were selected from January to December 2013 in Affiliated Tumor Hospital of Guangxi Medical University，and were randomly divided into for 166 cases of patients with breast cancer group (observation group，n = 166) and 40 cases of healthy people as normal healthy group (control group，n = 40).Immunohistochemistry envision two-step was used to detect the expression of estrogen receptor (ER)，progesterone receptor (PR)，human epidermal growth factor receptor-2 (HER-2) and Ki-67，using flowcytometry to detect the two group the of peripheral blood lymphocyte subgroup of CD3+，CD4+，CD8+，CD16+CD56+，CD19+ activity，combined with the clinical and pathological features were analyzed and compared. Results Compared with the normal healthy group ，the percentage of CD3+ and CD4+/CD8+ was significantly decreased in the groups of Luminal A，Luminal B type and HER-2 over expression (P<0.05).In the four kinds of molecular subtypes，the activity of CD4+ and CD19+ was significantly decreased compared with the normal healthy group (P<0.05).The activity of NK (CD16+ CD56+) of triple negative was significantly decreased compared with the normal healthy group (P<0.05)； Histological gradeⅡ had a significantly lower activity of CD4+ than the group of histology grade Ⅰ (34.35±9.03 vs 38.12±8.75， P<0.05).The histological grade Ⅲ had a significantly lower activity of NK (CD16+CD56+) than the histological gradeⅡ (13.92±6.34 vs (16.15±7.98， P<0.05).The activity of CD4+ and CD4+/CD8+ ratio in patients with lymph node metastasis were significantly lower than the patients without lymph node metastasis (P<0.05). Conclusion The determination of peripheral blood lymphocyte subsets in patients with different molecular subtypes of breast cancer patients has a certain significance in the state of immune function，which can contribute to the observation of the disease，curative effect monitoring and prognosis., 百拇医药(韦常宏 宁淑芳 韦文娥)
[关键词] 乳腺癌；淋巴细胞亚群；分子分型；临床病理特征
[中图分类号] R737.9 [文献标识码] A [文章编号] 1674-4721(2016)04(b)-0008-04
[Abstract] Objective To detect the changes of peripheral blood lymphocyte subsets in patients with different subtypes of breast cancer，and explore the relationship between different subtypes of breast cancer and their clinical pathological characteristics. Methods A total of 206 patients with women breast disease were selected from January to December 2013 in Affiliated Tumor Hospital of Guangxi Medical University，and were randomly divided into for 166 cases of patients with breast cancer group (observation group，n = 166) and 40 cases of healthy people as normal healthy group (control group，n = 40).Immunohistochemistry envision two-step was used to detect the expression of estrogen receptor (ER)，progesterone receptor (PR)，human epidermal growth factor receptor-2 (HER-2) and Ki-67，using flowcytometry to detect the two group the of peripheral blood lymphocyte subgroup of CD3+，CD4+，CD8+，CD16+CD56+，CD19+ activity，combined with the clinical and pathological features were analyzed and compared. Results Compared with the normal healthy group ，the percentage of CD3+ and CD4+/CD8+ was significantly decreased in the groups of Luminal A，Luminal B type and HER-2 over expression (P<0.05).In the four kinds of molecular subtypes，the activity of CD4+ and CD19+ was significantly decreased compared with the normal healthy group (P<0.05).The activity of NK (CD16+ CD56+) of triple negative was significantly decreased compared with the normal healthy group (P<0.05)； Histological gradeⅡ had a significantly lower activity of CD4+ than the group of histology grade Ⅰ (34.35±9.03 vs 38.12±8.75， P<0.05).The histological grade Ⅲ had a significantly lower activity of NK (CD16+CD56+) than the histological gradeⅡ (13.92±6.34 vs (16.15±7.98， P<0.05).The activity of CD4+ and CD4+/CD8+ ratio in patients with lymph node metastasis were significantly lower than the patients without lymph node metastasis (P<0.05). Conclusion The determination of peripheral blood lymphocyte subsets in patients with different molecular subtypes of breast cancer patients has a certain significance in the state of immune function，which can contribute to the observation of the disease，curative effect monitoring and prognosis., 百拇医药(韦常宏 宁淑芳 韦文娥)