肿瘤相关CD66b阳性中性粒细胞对预测宫颈癌Ⅰb至Ⅱa期复发的价值

摘要

Objective:To investigate the prognostic effect of polymorphnuclear neutrophil (PMN) in cervical cancer. Methods:Patients (n=92) who underwent curative surgery for the treatment of stage Ib and IIa cervical cancer according to the International Federation of Gynecology and Obstetrics (FIGO) were assessed to determine their tumor-infiltrating CD66b-positive neutrophils through immuno-histochemistry. Assessment results were then analyzed to identify their correlation with recurrence-free survival (RFS) as an end point. Kaplan-Meier method was used for survival curve analysis, and a Cox proportional hazard model was utilized for univariate and multi-variate analyses. Results:The RFS of the group with a density of CD66b-positive neutrophils above the median in cervical cancer tis-sues was significantly shorter than that of the group with a density of CD66b-positive neutrophils below the median (P=0.001). Univari-ate and multivariate analyses revealed adenocarcinoma (HR=3.020;95%CI=1.340-6.805;P=0.008), lymph node metastasis (HR=2.450;95%CI=1.065-5.637;P=0.035), and high neutrophil density (HR=2.866;95%CI=1.274-46.447;P=0.011) as independent prognostic fac-tors of short RFS. Conclusion:The increasing number of tumor-infiltrating neutrophils in cervical cancer tissues was correlated with short RFS of patients with cervical cancer.%目的:探讨宫颈癌组织中的多形核嗜中性粒细胞(polymorphnuclear neutrophil,PMN)数量在预测宫颈癌复发中的作用.方法:回顾性分析1999年2月至2006年12月湖北省妇幼保健院及武汉大学中南医院92例初治宫颈癌Ⅰb~Ⅱa期患者的临床病理资料.采用免疫组织化学法检测宫颈癌组织中阳性CD66b的PMN数量,计算PMN数量平均值.将患者按宫颈癌组织中PMN浸润数量分组,数量>PMN平均值为A组,数量≤PMN平均值为B组.以无复发生存(recurrence free survival,RFS)为结点,采用Kaplan-Meier法进行单因素分析,采用Cox风险回归模型进行多因素分析.结果:A组的RFS期明显短于B组(P=0.001).单因素及Cox风险回归模型多因素分析结果显示,腺癌(HR为3.020,95%CI为1.340~6.805,P=0.008)、淋巴结转移(HR为2.450,95%CI为1.065~5.637,P=0.035)、PMN浸润数量增加(HR为2.866,95%CI为1.274~46.447,P=0.011)为宫颈癌患者RFS的独立危险因素.结论:宫颈癌组织中PMN数量的增加与宫颈癌患者RFS期缩短相关,是宫颈癌患者预后不良的一个潜在预测指标.