【摘要】 背景与目的:肿瘤相关巨噬细胞(tumor-associated macrophage,TAM)浸润与肿瘤进展有关。本研究探讨TAM在卵巢癌组织中的浸润及对卵巢癌患者生存和预后的影响。方法:应用免疫组化方法检测卵巢癌及卵巢良性病变组织中TAM的特异性标志物CD68,了解TAM在卵巢癌组织中和卵巢良性病变中的浸润密度,并比较TAM高密度组与低密度组卵巢癌患者的生存差异,对影响预后的多个临床病理因素进行单因素及多因素分析。结果:67例卵巢癌组织标本中TAM平均密度为57.7/HP,22例卵巢良性病变组织标本中TAM平均密度为25.3/HP。在卵巢癌组织中TAM浸润密度较良性病变组织中明显为高(P<0.01)。卵巢癌患者中TAM低密度组的中位生存时间为(129.2±12.3)个月,5年累积生存率为73.3%;TAM高密度组的中位生存时间为(69.1±11.6)个月,5年累积生存率为41.2%。TAM低密度浸润卵巢癌患者5年生存率较TAM高密度患者为高(P=0.01)。在卵巢癌患者中,浆液性癌、中低分化癌及年龄大于40岁患者的癌组织中,TAM浸润较明显。多因素分析显示:组织学分级及TAM浸润的密度是影响晚期上皮性卵巢癌生存的独立的预后因子。结论:晚期上皮性卵巢癌组织中有明显的TAM浸润,TAM高密度浸润状态提示预后不良。更多还原

【Abstract】 Background and Objective:Tumor-associated macrophage(TAM) infiltration promotes the progression of various malignancies.This study was to investigate the influence of TAM infiltration on the survival and prognosis of patients with ovarian cancer.Methods:The expression of CD68,a TAM-specific marker,in 67 specimens of ovarian cancer and 22 specimens of benign ovarian lesion was detected by SP immunohistochemistry to investigate the density of TAM.The correlation of TAM density to the prognosis of ovarian cancer was analyzed.Cox multivariate proportional hazard model was used to analyze prognostic factors of ovarian cancer.Results:Observing under ×400 lens,the mean density of TAM was significantly higher in ovarian cancer than in benign ovarian lesions(57.7 vs.25.3 per vision field,P<0.01).The 5-year survival rate was significantly higher in low-density TAM group than in high-density TAM group of ovarian cancer patients(73.3% vs.41.2%,P=0.01).Univariate analysis found that TAM infiltration was more obvious in serous carcinoma,moderately and poorly differentiated carcinoma and in patients aged ≥40 than in the counterparts.Multivariate analysis revealed that histological grade and TAM infiltration status are independent predictors for overall survival.Conclusion:TAM infiltration is obvious in advanced ovarian cancer,which indicates poor prognosis.更多还原