[关键词]
[摘要]
目的:探讨非小细胞肺癌(non-small cell lung carcinoma,NSCLC)组织中Foxp3+调节性T细胞(regulatory T cell,Treg)与18F-脱氧葡萄糖(fluorodeoxyglucose, FDG) PET/CT原发灶最大标准摄取值(maximum standardized uptake value, SUVmax)的相关性及其对临床预后的影响。方法:收集2008年3月至2014年10月天津医科大学肿瘤医院收治的122例原发性NSCLC患者的临床、影像、病理、组织标本及随访资料。采用免疫组化法检测肺癌组织中Treg浸润情况。采用Kaplan-Meier法分析患者生存情况,并分析Treg浸润情况与原发灶SUVmax的相关性,及与各临床病理因素的关系。结果: Treg浸润情况与原发灶SUVmax呈正相关(r=0.291,P=0.001)。Treg及SUVmax均以临界值(cut off)值分高低两组,单因素分析显示Treg、SUVmax是影响患者预后的危险因素;临床资料分析显示,肿瘤越大、肿瘤分期越高,Treg浸润越严重(P<0.05)。Cox多因素分析显示肿瘤TNM分期 (HR=7.537, 95%CI:1.191-2.855,P=0.006)为患者生存的独立预后影响因子。结论: NSCLC组织中Treg浸润与PET/CT SUVmax正相关,PET/CT SUVmax可提示NSCLC患者肿瘤微环境中Treg浸润情况,对判断患者临床预后及临床用药有一定的指导作用。
[Key word]
[Abstract]
Objective:To investigate the correlation between Tregs infiltration in non-small cell lung carcinoma (NSCLC) tissues and SUVmax for primary lesion in PET-CT, and its effect on prognosis of NSCLC. Methods: One hundred and twenty two samples of primary NSCLC patients diagnosed in Cancer Institute and Hospital affiliated to Tianjin Medical University during March 2008 to October 2014 were collected, as well as their imaging, clinical and pathological data and follow-up information. Immunohistochemistry was used to detect the Tregs infiltration of carcinoma tissues. Survival outcomes were analyzed using the Kaplan-Meier method. Correlations between Tregs infiltration and SUVmax of primary lesions, as well as other clinicopathological factors were analyzed using Pearson correlation analysis and Spearman rank correlation analysis. Results: There was a positive correlation between Tregs infiltration and SUVmax (r=0.291, P=0.001). Tregs and SUVmax were divided into two groups respectively at the level of cut off value. Univariate analysis showed that Tregs and SUVmax were risk factors for the prognosis of patients. Clinical data also demonstrated that there was positive correlation between Tregs and tumor size, TNM stage (P<0.05). Multivariate Cox analysis demonstrated that tumor TNM stage (HR=7.537, 95% CI:1.191-2.855, P=0.006) was independent predictors for survival. Conclusion: There was a positive correlation between Tregs infiltration and SUVmax; PET/CT SUVmax may indicate Tregs infiltration in the tumor microenvironment of NSCLC patients, and it may play important role in predicting clinical prognosis and guiding treatment for NSCLC patients.
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[基金项目]
国家科技支撑计划资助项目(No.2015BA112B12);国家自然科学基金项目(No.81272221,No.81401887)