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目的:观察人乳腺癌和胃癌局部引流淋巴结(LDLN)从无转移、微转移到晚期转移过程中,免疫组织学变化及免疫活性细胞(ICC)的分布特征。方法:采用传统的病理学方法,对22例乳腺癌LDLN(71个)和7例进展期胃癌LDLN(28个)进行组织形态学分类,并以抗穿孔素、抗颗粒酶B、抗CD8、抗CD56、抗CD68、抗S-100、抗CD134及抗CD25单克隆抗体(mAb)进行催化信号放大(Catalyzedsignalamplification,CSA)免疫组化染色,检测肿瘤LNDN中ICC的分布。结果:肿瘤LDLN中以副皮质区增生和窦组织细胞增生为主,细胞毒性T淋巴细胞(CTL)及树突状细胞(DC)的数量,从无转移、微转移到晚期转移过程中有逐渐减少的趋势。在无和微转移的淋巴结内,穿孔素+、颗粒酶B+及S100+DC的数量高于晚期转移淋巴结(P<0.05);而S100+DC不仅数量减少,而且其形态也有变化,呈多角形、星形,并有胞质突起,与周围淋巴细胞接触呈活化状态的DC变为椭圆形,少有胞质突起或呈短突起的静止状态的DC。CD134+细胞及CD25+细胞的数量在晚期转移淋巴结中明显高于无和微转移淋巴结(P<0.01)。ICC在无和微转移的前哨和非前哨淋巴结中的分布无统计学意义(P>0.05)。结论:肿瘤LDLN中ICC分布的变化,提示随着肿瘤的进展,其免疫微环境向抑制机体抗肿瘤免疫的方向偏移。
OBJECTIVE: To observe the distribution of immunoreactive cells (ICC) in local lymph node (LDLN) from non-metastasis, micrometastasis to late metastasis in human breast cancer and gastric cancer. Methods: Twenty-two cases of LDLN (71 breast cancer) and 7 advanced gastric cancer (LDLN) were classified by histopathology. The anti-perforin, anti-granzyme B, anti-CD8, The anti-CD56, anti-CD68, anti-S-100, anti-CD134 and anti-CD25 monoclonal antibodies (mAb) were subjected to the catalytic signal amplification (CSA) immunohistochemical staining to detect the distribution of ICC in the tumor LNDN. Results: The proliferation of paracortical hyperplasia and sinusoidal hyperplasia of the tumor were mainly found in the tumor LDLN. The number of cytotoxic T lymphocytes (CTL) and dendritic cells (DC) gradually decreased from no metastasis to micrometastasis to late metastasis Reduce the trend. The numbers of perforin +, granzyme B + and S100 + DC were higher in lymph node without metastasis than in advanced lymph node metastasis (P <0.05), while the number of S100 + DC not only decreased, but also changed in morphology , Star-shaped, and cytoplasmic processes. The DCs in the activated state in contact with the surrounding lymphocytes became oval, with few cytoplasmic processes or DCs in the quiescent state with short processes. The number of CD134 + cells and CD25 + cells in the late metastasis lymph nodes was significantly higher than that in the non-metastatic lymph nodes (P <0.01). The distribution of ICC in non-micrometastasis sentinel and non-sentinel lymph nodes was not statistically significant (P> 0.05). Conclusion: The changes of ICC distribution in the tumor LDLN suggest that as the tumor progresses, the immune microenvironment shifts to suppress the anti-tumor immunity of the body.