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目的:分析非小细胞肺癌(non-small cell lung cancer,NSCLC)组织错配修复蛋白MLH1、MSH2和MSH6的表达和T淋巴细胞浸润情况,探讨微卫星不稳定(microsatellite instability,MSI)与NSCLC组织T淋巴细胞浸润的关系。方法:收集天津医科大学肿瘤医院2004年至2010年NSCLC组织标本100例,应用免疫组化法检测癌组织中MLH1、MSH2和MSH6的表达,以其中1种及1种以上蛋白表达阴性者判定为MSI;同时检测T淋巴细胞浸润情况,并分析MSI与NSCLC临床病理特征的关系。结果:NSCLC组织中MSI检出率24%,少于微卫星稳定(microsatellite stability,MSS)。MSI NSCLC组织中T淋巴细胞浸润明显高于MSS者。免疫组化结果显示:MSI NSCLC组织CD3~+、CD4~+、CD8~+ T淋巴细胞浸润数目明显多于MSS NSCLC组织,两者差异有统计学意义(P<0.05)。MSI与患者的年龄有关(P<0.05),而与患者的性别、肿瘤组织类型、肿瘤大小、淋巴结有无转移和肿瘤有无远处转移均无关(P>0.05)。结论:MSI影响NSCLC肿瘤免疫微环境,MSI的检测可为NSCLC免疫治疗效应提供预测指标。
OBJECTIVE: To analyze the expression of mismatch repair proteins MLH1, MSH2 and MSH6 and the infiltration of T lymphocytes in non-small cell lung cancer (NSCLC) and to explore the relationship between microsatellite instability (MSI) and NSCLC tissue T lymphocyte infiltration of the relationship. Methods: 100 cases of NSCLC tissue samples collected from Tumor Hospital of Tianjin Medical University from 2004 to 2010 were collected. The expression of MLH1, MSH2 and MSH6 in cancerous tissues was detected by immunohistochemistry. One or more of them were negative for protein expression MSI. T lymphocyte infiltration was detected at the same time, and the relationship between MSI and clinicopathological features of NSCLC was analyzed. Results: The detection rate of MSI in NSCLC tissues was 24%, less than the microsatellite stability (MSS). T lymphocyte infiltration in MSI NSCLC tissues was significantly higher than that in MSS. The results of immunohistochemistry showed that the number of CD3 ~ +, CD4 ~ +, CD8 ~ + T lymphocyte infiltration in MSI NSCLC was significantly higher than that in MSS NSCLC, the difference was statistically significant (P <0.05). MSI was related to patient’s age (P <0.05), but had no correlation with patient’s sex, tumor type, tumor size, lymph node metastasis and tumor distant metastasis (P> 0.05). Conclusion: MSI can affect the immune microenvironment of NSCLC. The detection of MSI can provide predictive value for immunotherapy of NSCLC.