CCR4在T1期肺腺癌组织中的表达及其临床意义∗

摘要

目的：探讨T1期肺腺癌肿瘤浸润淋巴细胞（ TILs）中趋化因子受体4（ CCR4）的表达及临床意义。方法采用组织芯片技术和免疫组织化学技术测定185例T1期肺腺癌TILs中CCR4的表达情况，分析CCR4表达与临床病理特征及预后的关系。结果 CCR4表达于TILs的胞浆，阳性表达率为（17�8±7�3）％，并以17�8％为界值分为低表达组和高表达组。CCR4阳性表达率与年龄、性别、吸烟史无关（ P＞0�05），与T分期、淋巴结转移、脉管浸润和复发有关（ P＜0�05）。 CCR4低表达组与高表达组患者的3年生存率分别为98�7％和88�1％，5年生存率分别为89�8％、88�1％，8年生存率分别为86�6％、51�6％，差异有统计学意义（ P＜0�05）；CCR4低表达组与高表达组患者的3年无复发生存率分别为93�3％、82�3％，5年无复发生存率分别为86�4％、74�5％，8年无复发生存率分别为83�4％、50�5％，差异有统计学意义（ P＜0�05）。结论 CCR4在T1期肺腺癌TILs中的高表达与肺腺癌侵袭性增强及淋巴结转移有关，有望成为预测肺腺癌预后和靶向治疗的指标。%Objective To investigate the expression of CC chemokine receptor 4( CCR4) in tumor infiltrating lymphocytes ( TILs) of T1 stage lung adenocarcinoma and analyze its correlation with clinicopathological characteristics and prognostic impact. Methods The expression of CCR4 in TILs was quantified by tissue microarray and immunohistochemistry in 185 T1 stage adenocarci⁃nomas. The relationship between the expression of CCR4 in TILs with clinicopathological characteristics and prognosis was analyzed. Results The expression of CCR4 was located in the nucleus of lymphocytes, with a positive expression ratio of(17�8±7�3)%. And patients were devided into high expression group and low expression group according 17�8%. The CCR4 expression was correlated with T stage, nodal involvement, lymphovascular invasion, and relapse( P<0�05) , but not with age, gender or smoking history( P>0�05) . The 5⁃year overall survival rate of CCR4 was 88�1%, lower than that of CCR4 low expression group( 89�8%) with statistically signifi⁃cant difference( P=0�038) . The 3⁃year overall survival rates of CCR4 high expression group and low expression group were 98�7% and 88�1%, the 5⁃year overall survival rates were 89�8% and 88�1%,and the 8⁃year overall survival rates were 86�6% and 51�6%,with statistical significance(P<0�05);The 3⁃year recurrence⁃free survival rates of CCR4 high expression group and low expression group were 93�3% and 82�3%, 3⁃year recurrence⁃free survival rates were 86�4% and 74�5%, and 8⁃year recurrence⁃free survival rates were 83�4% and 50�5% with statistical significance( P<0�05) . Conclusion The expression of CCR4 in TILs significantly increases with the aggression of lung adenocarcinoma and lymph node metastasis, indicating that it may be a predictor of prognosis and therapeutic tar⁃get in patients with lung adenocarcinoma.