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目的进一步了解直肠癌新辅助治疗后肿瘤组织局部免疫状态的改变,为直肠癌新辅助治疗提供更多认识。方法选取新辅助治疗(FOLFOX6方案)的中低位直肠癌患者60例(治疗组)及未行新辅助治疗的中低位直肠癌患者60例(对照组)的术后石蜡包埋组织进行对照研究。在高倍镜下对2组癌组织标本切片进行肿瘤浸润淋巴细胞(TIL)计数,采取鼠抗人单克隆抗体S-100,采用免疫组织化学SP法检测2组癌组织中树突状细胞(DC)的形态和分布特征,并对其阳性细胞计数。结果①TIL反应情况:TIL主要集中于癌周区,聚集存在,形态不规则,核大,胞质少。治疗组的TIL反应阳性率为75.00%(45/60),对照组的TIL反应阳性率为90.00%(54/60),治疗组低于对照组(χ2=10.58,P=0.014)。②S-100阳性DC:S-100蛋白阳性标记的DC呈棕黄色,主要分布在癌组织周围,定位在细胞核和细胞浆,治疗组的S-100阳性DC数为(36.85±11.17)/HPF,对照组S-100阳性DC数为(26.50±7.68)/HPF,治疗组高于对照组(t=5.91,P=0.001)。结论新辅助治疗可使肿瘤的局部TIL减少,DC增加,对患者肿瘤局部免疫功能产生影响
Objective To know more about the changes of local immune status of neoplasms after neoadjuvant therapy in rectal cancer and to provide more knowledge for neoadjuvant treatment of rectal cancer. Methods Sixty patients with low and middle rectal cancer treated with neoadjuvant chemotherapy (FOLFOX6 regimen) and 60 patients with moderate and low rectal cancer without neoadjuvant therapy (control group) were enrolled in this study. Tumor infiltrating lymphocytes (TILs) were counted in 2 groups of high-power microscope sections. The mouse anti-human monoclonal antibody S-100 was used to measure the expression of TIL. The dendritic cells (DCs) ) Morphology and distribution characteristics, and its positive cell count. Results ① TIL response: TIL mainly concentrated in the peritumor area, aggregated, irregular shape, large nucleus, less cytoplasm. The positive rate of TIL in the treatment group was 75.00% (45/60). The positive rate of TIL in the control group was 90.00% (54/60). The treatment group was lower than the control group (χ2 = 10.58, P = 0.014). (2) DCs positive for S-100 positive DC: S-100 protein were brownish yellow, mainly distributed in the periphery of the cancer tissues and located in the nucleus and cytoplasm. The positive DC number of S-100 in the treatment group was (36.85 ± 11.17) / HPF, The positive DC number of S-100 in the control group was (26.50 ± 7.68) / HPF, which was higher in the treatment group than in the control group (t = 5.91, P = 0.001). Conclusion Neoadjuvant therapy can reduce the local tumor TIL, DC increased, the impact of local tumor immune function