癌组织树突状细胞浸润与肾癌预后及转移的关系

OBJECTIVE: To investigate the relation of dendritic cell (DC) infiltration to the prognosis and lymph node metastasis of renal cell carcinoma. METHOD: The tissue specimens were obtained from 69 patients with renal cell carcinomas, who were treated surgically from 1994 to 2000 in our hospital and followed up for over 2 years. ABC immunohistochemical method using S-100 protein antibody was employed to examine the tumor tissues and the DCs was counted. RESULTS: The patients showing no signs of tumor recurrence within 2 years postoperatively had significantly greater number of S-100(+) DCs in the tumor tissues than that of patients with recurrence in 2 years (61.3 +/- 14.7/mm(2) vs 31.4 +/- 11.6/mm(2)). The number of S-100(+) DCs of the group with lymph node metastasis was much lower than that of the group without the metastasis (28.8 +/- 10.4/mm(2) vs 62.6 +/- 13.5/mm(2)). CONCLUSION: The density of DC infiltration is closely related to the prognosis and lymph node metastasis, which may be used as a good indicator for prognostic assessment of renal cell carcinoma.     

树突状细胞与肾癌关系研究

树突状细胞是专职的抗原呈递细胞,具有激活T细胞和诱导免疫反应的特殊功能。大量研究显示,树突状细胞在抗肿瘤的免疫反应、肿瘤监视等过程中均起到重要作用。树突状细胞免疫治疗已广泛应用于临床,并取得一定的进展。在我国,肾癌是泌尿系统较为常见的肿瘤,现就树突状细胞与肿瘤免疫逃避关系,采用树突状细胞治疗肾癌的临床应用状况及其前景进行综述。     

乳腺癌中树突状细胞浸润的临床意义

目的 :探讨乳腺癌中肿瘤浸润性树突状细胞 (TIDC)与肿瘤发生发展的关系及对患者预后的影响。方法 :用免疫组化法 (S -P法 )检测 5 8例乳腺癌中树突状细胞浸润程度及ER的表达 ,其中 30例检测PCNA表达 ,分析TIDC与PCNA、ER表达的关系。进行随访并以COX模型做生存分析。结果 :树突状细胞浸润与PCNA表达呈负相关 ,r=- 0 .6 96 ,肿瘤不同组织学分级及不同ER状况的TIDC浸润有显著性差异 ,TIDC浸润影响患者预后。结论 :TIDC抑制乳腺癌细胞的增殖并影响其分化状况 ,可作为评估乳腺癌预后的因素之一。     

膀胱移行细胞癌内树突状细胞和T淋巴细胞的检测及其意义

目的：研究膀胱移行细胞癌内树突状细胞（DC）及T淋巴细胞的浸润程度与肿瘤的病理分级和预后的关系。方法：应用免疫组化ABC法，选用抗S－100蛋白多克隆抗体和CD45RO单克隆抗体对55例膀胱移行细胞癌内的DC和T淋巴细胞进行检测。结果：膀胱移行细胞癌内DC及T淋巴细胞的浸润程度与肿瘤的病理分级和预后关系十分密切，结论：作为抗原提呈细胞的DC和具有特异抗肿瘤免疫活性的T淋巴细胞能较全面客观地反映膀胱移行细胞癌宿主局部抗肿瘤免疫状态，两者是判断膀胱移行细胞癌预后的可靠性指标。     

大肠癌组织树突状细胞与病理特征及预后的关系

用Ｓ－１００蛋白本ＡＢＣ免疫组化法定量检测３１例正常大肠粘膜，５４例大肠腺瘤和１４４例大肠癌细胞的树突状细胞。     

肾细胞癌病理形态与临床预后的关系

One hundred and six cases of renal cell carcinoma (RCC) were studied with an objective to investigate the effects of clinical stages, histological patterns (grading), cell types, nuclear grading and tumor sizes on the postoperative survival time of the patients. The results showed that there were no statistical differences in the postoperative survival time among different histological patterns and among different cellular types, such as clear cell, granular cell and mixed cell. But those with either diffuse sarcomatoid pattern or undifferentiated cell type had poor prognosis. The patients with tumor size greater than 10 cm in diameter had poor prognosis. The prognosis-deciding factors for RCC patients were the clinical staging and nuclear grading. We suggest that the nuclear grading of RCC be noted in every pathological report, so as to provide reference for clinical evaluation of the prognosis and further treatment.     

原位树突状细胞和结直肠癌浸润及淋巴结转移的关系

用Ｓ—１００蛋白质抗体对１４４例结直肠癌组织和３１例正常大肠粘膜进行ＡＢＣ免疫组化染色。结果表明结直肠癌原位树突状细胞（ＤＣ）较正常大肠粘膜明显增多（Ｐ＜０．０１）。随着癌的浸润及淋巴结转移，原位ＤＣ减少。提示ＤＣ在增强机体抗肿病免疫力以阻止癌的浸润、转移方面有重要意义。     

原位树突状细胞和结志肠癌浸润及淋巴结转移的关系

用Ｓ－１００蛋白质抗体对１４４例结直肠癌组织和３１例正常大肠粘膜进行ＡＢＣ免疫组化染色。结果表明结直肠癌原位树突状细胞较正常大肠粘膜明显增多。     

Ki-67抗原在肾细胞癌中的表达及其预后的关系

探讨Ki-67抗原在肾细胞癌中的表达及预后。方法:应用免疫组化方法检测52例手术切除后的肾癌标本中的Ki-67抗原表达并进行随访。结果:Ki-67增殖指数(阳性细胞在肿瘤细胞中所占的百分比)与肾癌临床分期、病理分级呈显著相关(F=27.57,P<0.0001)。Ki-67指数与肾癌预后相关,将Ki-67指数分为三个等级:A<10％,B10％～30％,C>30％,用Kaplan-Meier法绘制生存率曲线并进行Log-rank检验,表明三组生存率曲线均有显著性差异(P<0.001)。结论:Ki-67增殖指数能较好地反映肾癌的恶性度并能评估预后,是一个较为理想的反映细胞增殖状态的指标。     

细胞粘附因子CD44v6表达与肺癌转移和预后的关系

目的　探讨细胞粘附因子CD4 4v6在肺癌组织中的表达及其与肺癌的转移和预后的关系。方法　应用免疫组化SP法检测CD4 4v6在 79例肺癌组织中的表达情况。结果　伴淋巴结转移者CD4 4v6表达阳性率为4 5 .4 5 % ( 2 0 / 4 4 ) ,无淋巴结转移者CD4 4v6表达阳性率为 5 3.33% ( 2 1/ 35 ) ,其差异有显著性 (P <0 .0 5 )。CD4 4v6阳性者生存率与阴性者之间有一定差别 ,但无统计学意义 (P >0 .0 5 )。结论　CD4 4v6表达与肺癌淋巴结转移有一定的关系 ,但其作用有待于进一步探讨 ;CD4 4v6表达与肺癌短期预后无关     

Colon metastasis of chromophobe renal cell carcinoma with sarcomatoid change

We present a rare case of colonic metastasis of renal cell carcinoma (RCC) and review the literature. A 54-year-old male was referred to our hospital with a history of bloody stools and fever. A right kidney tumor measuring about 10 cm in diameter was found by abdominal computed tomography. Right radical nephrectomy and a right hemicolectomy with ileotransversostomy were performed. Pathological diagnosis was chromophobe RCC with sarcomotoid change involving the colon. Chromophobe RCC with sarcomotoid change is very rare.

     

肾细胞癌骨转移病理特点分析与配对研究

目的 分析肾细胞癌骨转移组织病理及免疫组织化学特点,探讨肾细胞癌骨转移的病理学相关特点与转移高危因素。方法 回顾性分析海军军医大学（第二军医大学）长征医院2012年1月至2017年12月收治的经病理确诊的1 694例肾细胞癌患者（未发生骨转移）与133例肾细胞癌骨转移患者的病理学特征与免疫组织化学特点,并对25例先后或同时于长征医院切除肾癌原发灶和骨转移灶的肾细胞癌患者的病理资料进行配对分析。结果 未发生骨转移肾细胞癌患者中男性所占比例（70.1%,1 188/1 694）低于骨转移肾细胞癌患者（84.2%,112/133）,肾透明细胞癌所占比例（83.4%,1 412/1 694）低于骨转移肾细胞癌患者（93.6%,103/110）,差异均有统计学意义（P均<0.01）。在未发生骨转移肾透明细胞癌患者和骨转移肾透明细胞癌患者中,Fuhrman核分级Ⅲ/Ⅳ级者分别占17.7%（247/1 398）和51.6%（32/62）,差异有统计学意义（P<0.001）。在配对分析的25例骨转移肾细胞癌患者中,11例（44.0%）组织病理学提示肿瘤侵犯或突破肾包膜,同期未发生骨转移肾细胞癌患者中18.9%（320/1 694）病理检查提示侵犯或突破肾包膜,发生骨转移的肾细胞癌患者侵犯或突破肾包膜的比例高于同期未发生骨转移的肾细胞癌患者（P=0.002）。配对分析显示肾脏原发灶中Ki-67标记指数低于骨转移灶[中位数（下四分位数,上四分位数）：5.0%（2.0%,6.0%）vs 6.0%（3.0%,15.0%）,P<0.001]。结论 肾透明细胞癌较肾非透明细胞癌更容易发生骨转移,男性、Fuhrman核分级Ⅲ/Ⅳ级和侵犯肾被膜是发生骨转移的高危因素。骨转移灶Ki-67标记指数较原发灶高,提示原发灶与转移灶的病理特点并不完全相同,获取骨转移组织进行病理分析或可指导治疗。     

肿瘤血管新生与肾癌进展及患者预后的关系

目的：研究肿瘤微血管密度（IMD）与肾癌进展及肾癌根治术后患者预后的关系。方法：采用免疫组织化学染色法对76例肾癌根治术的手术切除标本进行IMD定量研究，观察IMD与肾癌病理分级，临床分期及转移行为的关系。同时结合病例随访资料研究IMD对根治术后患者预后判断的价值。结果：随临床分期增加，IMD值增加（P＜0．01）；不同病理分级患者IMD值无显著性差异（P＞0．05），IMD高者术后生存时间短；逐步回归分析表明，IMD与肾癌根治术后患者的预后关系密切。结论：IMD与肾癌的恶化，进展有关，并对肾癌根治术后患者预后的判断具有重要意义。     

A randomized controlled trial of postoperative tumor lysate-pulsed dendritic cells and cytokine-induced killer cells immunotherapy in patients with localized and locally advanced renal cell carcinoma

Background  It remains a challenge to inhibit the local recurrence or distant metastasis of localized or locally advanced renal cell carcinoma (RCC) after surgical resection. We investigated the feasibility, safety and efficacy of immunotherapy using autologous tumor lysate (TL)-pulsed dendritic cells (DCs) and cytokine-induced killer (CIK) cells in patients with localized or locally advanced RCC.

Methods  From January 2001 to July 2009, we collected 137 patients that met the selection criteria and randomly divided them into three groups. After surgery, immunotherapy with TL-pulsed DCs-CIK cells (DC-CIK group) and interferon (IFN)-α (IFN-α group) was performed in 46 patients, respectively. The other 45 patients received no postoperative adjuvant therapy (the control group). The changes in the numbers of T lymphocyte subsets, including CD4⁺CD25^high regulatory T cells (Treg), were determined before the operation and after immunotherapy. The overall survival was compared among the three groups.

Results  An increase of the CD4⁺/CD8⁺ ratio and a decrease of CD4⁺CD25^high cells were observed after TL-pulsed DC-CIK cells or IFN-α immunotherapy. All patients tolerated the TL-pulsed DC-CIK cells immunotherapy very well, and side effects in the DC-CIK group were less than in the IFN-α group. The metastasis and recurrence rates were significantly decreased after TL-pulsed DC-CIK cells or IFN-α immunotherapy compared with the control group (P <0.01). The Log-rank test showed that the overall survival rates were significantly higher in the DC-CIK group and IFN-α group than that in the control group (P <0.01), but there was no difference between the DC-CIK group and IFN-α group (P >0.05).

Conclusion  Postoperative immunotherapy with TL-pulsed DC-CIK cells may prevent recurrence/metastasis and increase the overall survival rate after surgery in localized or locally advanced RCC.

     

肾嫌色细胞癌临床病理及免疫组织化学分析

目的:探讨肾嫌色细胞癌的临床病理特点、免疫学表型及预后。方法:对23例肾嫌色细胞癌进行光镜观察、免疫组化研究及随访,其中2例进行电镜观察。结果:23例肾嫌色细胞癌中瘤细胞呈大圆形或多角形,膜较厚,胞质半透明细网状,可见核沟及核异型;部分细胞胞质嗜酸,可见明显透明的核周空晕。免疫组化表达率分别为:EMA和Ksp-cadherin全部(+),CD10(+)(11/23),vimentin全部(-),CK7(+)(17/23),CD117(+)(22/23)。23例中2例伴有肉瘤样癌成分,21例存活,2例死亡。结论:肾嫌色细胞癌是一种少见的来源于集合管上皮细胞恶性肿瘤,临床预后好,伴肉瘤样癌成分者预后较差。     

胆囊小细胞癌伴肝脏和腹膜后淋巴结转移1例报告及文献复习

分析胆囊小细胞癌（SCC）患者的临床表现、影像学和病理学特征和治疗方法,提高临床医师对该疾病的认识。     

舌鳞状细胞癌颈淋巴结转移的影响因素

目的:了解影响舌鳞状细胞癌颈淋巴结转移的临床病理因素.方法:回顾性分析90例舌鳞状细胞癌的发生部位、T分类、分化程度、肿瘤浸润方式及周围淋巴细胞浸润与肿瘤转移的关系.结果:舌边缘部和舌腹部肿瘤转移淋巴结涉及Ⅰ～Ⅳ颈部平面,舌前部和舌根部肿瘤转移淋巴结涉及Ⅰ～Ⅲ颈部平面;在所有舌鳞状细胞癌患者中,转移淋巴结在各平面的构成比依次为平面Ⅱ(40.48%),平面Ⅰ(35.71%),平面Ⅲ(19.05%),平面Ⅳ(4.76%)和平面V(0%).T分类与淋巴结转移的关系为:T18.33%、T219.44%、T3 38.00%、T447.62%(x2=8.848,P=0.037);分化程度与淋巴结转移发生率为:Ⅰ～Ⅱ级14.87%,Ⅲ级93.75%(x2=39.850,P＜0.001);浸润方式与淋巴结转移的关系:Ⅰ～Ⅱ型无淋巴结转移,Ⅲ型为25.00%,ⅣC～ⅣD型为58.62%;而肿瘤周围淋巴细胞浸润与淋巴结转移无明显相关性(P=0.787).结论:舌鳞状细胞癌的颈淋巴结转移主要累及Ⅰ～Ⅳ颈部平面,以Ⅰ～Ⅲ颈部平面为主,其转移的发生与肿瘤的T分类、分化程度、浸润方式有明显相关性.     

汉族人肾透明细胞癌肺转移小鼠模型的建立及肺转移细胞亚株的筛选

目的:建立可稳定传代的肾透明细胞癌小鼠肺转移模型,并在此基础上初步筛选出肾透明细胞癌特异性鼠肺转移细胞亚株,为后续研究奠定基础。方法:选用本实验室前期建立的肾透明细胞癌细胞株RCC05-TXJ,体外扩增培养制成细胞悬液后注射于NOD-SCID小鼠颈背部皮下,成瘤后取出瘤组织接种于另外NOD-SCID小鼠的肾包膜下,待有肉眼可见瘤块后,处死小鼠并取出肿瘤组织接种于新NOD-SCID小鼠的肾包膜下,反复数轮,直至出现稳定的鼠肺转移模型。此时取模型鼠肺转移组织,一部分继续接种于新鼠肾包膜下,反复数轮,尝试以转移组织诱导肺转移;另一部分进行原代培养,细胞经体外扩增纯化后制成悬液接种于新鼠肾包膜,数轮循环至产生肺转移,筛选能产生稳定鼠肺转移的细胞亚株。整个筛选过程均观察记录原位成瘤、淋巴及肺转移形成情况,并对肿瘤组织进行病理组织学观察及CA9（肾癌标志）、CD133（干细胞标志）表达检测。结果:以RCC05-TXJ细胞株接种所致NOD-SCID小鼠颈背部皮下肿瘤组织作为移植瘤材接种鼠肾包膜在第2轮即出现鼠肺转移,此后3~6轮以鼠肺转移组织移植肾包膜下,均能成功诱导转移。以鼠肺转移组织原代培养RCC细胞均获成功,第6轮原代培养细胞扩增纯化后制成的细胞悬液（RCC05-TXJ-L）接种于鼠肾包膜下,出现特异性肺转移,重复2轮实验结果稳定。RCC05-TXJ-L细胞具有生长速度快（传代时间约为2 d）、原位成瘤时间短（1周左右）、接种后转移性较强、CA9及CD133表达升高等特点。结论:RCC05-TXJ在NOD-SCID小鼠体内多轮反复筛选可建立稳定的肾细胞癌鼠肺转移动物模型;在此基础上筛选出的肺转移性细胞亚株RCC05-TXJ-L可稳定诱导NOD-SCID鼠产生肺部转移。