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目的探讨胃癌组织中调节性T细胞(regulatory T cells,Tregs)浸润的临床意义和机制。方法免疫组织化学染色检测80例胃癌组织内Foxp3表达,分析Tregs浸润与胃癌患者临床因素的相关性,及其对预后的预测作用。流式细胞技术检测胃癌细胞株AGS细胞上清对Tregs趋化、诱导和增殖作用。结果 Foxp3在胃癌组织中的表达与淋巴结转移和临床分期相关,Foxp3低表达组患者生存期明显长于Foxp3高表达组患者(P=0.028)。流式细胞技术检测显示AGS细胞上清组趋化Foxp3阳性T细胞比例较无血清培养基明显增加[(6.04±1.02)%与(2.19±0.19)%,P=0.011];经AGS细胞上清培养后Foxp3阳性T细胞比例较无血清培养基明显增加[(9.01±0.67)%与(7.68±0.80)%,P<0.001];AGS细胞培养上清对Tregs增殖无明显作用。结论 Tregs在肿瘤组织内浸润可能与胃癌进展相关,对胃癌患者预后可能有预测作用,胃癌细胞可能通过分泌可溶性因子,趋化或诱导生成Tregs导致其在肿瘤中的浸润。
Objective To investigate the clinical significance and mechanism of regulatory T cells (Tregs) infiltration in gastric cancer. Methods The expression of Foxp3 was detected in 80 cases of gastric cancer by immunohistochemical staining. The correlation between Tregs infiltration and clinical factors in gastric cancer was analyzed. Flow cytometry was used to detect the chemotaxis, induction and proliferation of Tregs in gastric cancer cell line AGS cell supernatant. Results The expression of Foxp3 in gastric cancer was related to lymph node metastasis and clinical stage. The survival of Foxp3 group was significantly longer than that of Foxp3 high expression group (P=0.028). Flow cytometry showed that the proportion of Foxp3-positive T cells in the supernatant of AGS cells was significantly higher than that in serum-free medium [(6.04±1.02)% vs. (2.19±0.19)%, P=0.011]; After incubation, the proportion of Foxp3-positive T cells was significantly higher than that of serum-free medium [(9.01±0.67)% vs. (7.68±0.80)%, P<0.001]; AGS cell culture supernatant had no significant effect on Tregs proliferation. Conclusion The invasiveness of Tregs in tumor tissues may be related to the progression of gastric cancer. It may have a predictive effect on the prognosis of gastric cancer patients. Gastric cancer cells may induce infiltration of tumors by secreting soluble factors, chemotaxis or induction of Tregs.