黄瑾瑾,杨宇石,孙紫君,范梦蕾,李翀瑶,薄莉,李小虎,徐澍
HUANG Jinjin,YANG Yushi,SUN Zijun,FAN Menglei,LI Chongyao,BO Li,LI Xiaohu,XU Shu

• 1:贵州医科大学附属医院病理科
• 2:贵阳市第二人民医院病理科

摘要(Abstract)：

目的 探讨乳腺浸润性导管癌肿瘤微环境CD163标记M2型肿瘤相关巨噬细胞（TAM）和CD31标记微血管密度（MVD）与患者临床病理特征的关系。方法 选取乳腺浸润性导管癌138例作为癌组织组，癌旁正常组织35例为癌旁正常组织组，采用免疫组化EnVision二步法检测两组标本中CD163标记M2型TAM和CD31标记MVD，使用χ~2检验分析癌组织组CD163标记M2型TAM和CD31标记MVD分别与乳腺癌临床病理特征的关系，使用Spearman法分析癌组织组CD163标记M2型TAM和CD31标记MVD相关性，利用KaplanMeier法分析癌组织组CD163标记M2型TAM和CD31标记MVD与乳腺癌预后的相关性。结果 CD163标记M2型TAM和CD31标记MVD在癌组织组高表达率均明显高于癌旁正常组织组（P<0.05）;CD163标记M2型TAM在病理组织学分级Ⅲ级中高表达率明显高于Ⅰ级和Ⅱ级，在Ki-67增殖指数≥20%者高表达率明显高于Ki-67增殖指数<20%者，伴有淋巴结转移患者高表达率明显高于无转移者，在HER-2阳性型乳腺癌高表达率明显高于其他分子分型；CD31标记MVD在肿瘤直径> 5cm者高密度表达率明显高于肿瘤直径2.0 <～≤5 cm者和肿瘤直径≤2.0 cm者，在Ki-67增殖指数≥20%者高密度表达率明显高于Ki-67增殖指数<20%者，在三阴性乳腺癌中高密度表达率明显高于其他分子分型（P<0.05）;CD163标记M2型TAM与CD31标记MVD表达呈正相关（r=0.180,P<0.05）;CD163标记M2型TAM及CD31标记MVD与乳腺浸润性导管癌患者预后无关（P> 0.05）。结论 乳腺浸润性导管癌微环境中CD163标记M2型TAM和CD31标记MVD的表达与肿瘤患者多项临床病理特征有关，可能会影响乳腺癌恶性生物学行为。
Objective To investigate the relationship between the expressions of CD163 labeled M2 type tumor associated macrophage( TAM) and CD31 labeled microvascular density( MVD) in the microenvironment of breast invasive ductal carcinoma and its clinicopathological characteristics.M ethods One hundred and thirty-eight cases with breast infiltrating ductal carcinoma were selected as the cancer tissue group, and 35 cases of adjacent normal tissue as the control group. The EnVision two-step immunohistochemical method was used to detect the expressions of CD163 labeled M2 type TAM and CD31 labeled MVD in the two groups. The χ~2 test was used to analyze the relationships between CD163 labeled M2 type TAM and CD31 labeled MVD and the clinicopathological characteristics of breast cancer, respectively. The Spearman method was used to analyze the correlation between CD163 labeled M2 type TAM and CD31 labeled MVD in the cancer tissue group. The KaplanMeier method was used to analyze the correlation between CD163 labeled M2 type TAM and CD31 labeled MVD and the prognosis of breast cancer, respectively.Result The high expression rates of CD163 labeled M2 type TAM and CD31 labeled MVD in the cancer tissue group were significantly higher than that in the control group, and the difference was statistically significant(P< 0. 05). The high expression rate of CD163 labeled M2 type TAM in grade Ⅲ was significantly higher than that in grade Ⅰ and grade Ⅱ（P< 0. 05）. The high expression rate of CD163 labeled M2 type TAM in the cases with Ki-67 proliferation index≥20% was significantly higher than those with Ki-67 proliferation index < 20%(P< 0. 05). The high expression rate of CD163 labeled M2 type TAM the cases with lymph node metastasis was significantly higher than the cases without lymph node metastasis(P<0. 05). The high expression rate of CD163 labeled M2 type TAM in HER-2 positive type was significantly higher than that in other moleculae types(P< 0. 05). The high rate of CD31 labeled MVD with tumor diameter > 5 cm was significantly higher than that of the cases with tumor diameter >2 cm and ≤5 cm and tumor diameter ≤2. 0 cm(P< 0. 05), respectively. The CD31 labeled MVD high rate in the cases with Ki-67 proliferation index≥20% was significantly higher than that in the cases with Ki-67 proliferation index < 20%(P< 0. 05). The CD31 labeled MVD rate in the cases with triple negative breast cancer was statistically significantly highest(P< 0. 05) in all moleculae types.The CD163 labeled M2 type TAM were positively correlated with CD31 labeled MVD expression(r=0. 180,P< 0. 05). There was no significant difference between CD163 labeled M2 type TAM and CD31 labeled MVD and prognosis of breast infiltrating ductal carcinoma(P> 0. 05), respectively.C onclusion The expressions of CD163 labeled M2 type TAM and CD31 labeled MVD in the microenvironment of breast invasive ductal carcinoma are associated with a number of clinicopathological features, which may influence the malignant biological behavior of breast cancer.

关键词(KeyWords)： 乳腺肿瘤;M2型肿瘤相关巨噬细胞;微血管密度;肿瘤微环境;CD163蛋白;CD31蛋白
breast cancer;M2 type tumor-associated macrophages;microvessel density (MVD);tumor microvessel;CD163 protein;CD31 protein

Abstract:

Keywords:

基金项目(Foundation): 贵州省卫生计生委科学基金项目（gzwjkj2018-1-062）;; 国家自然科学基金培育项目（I-2020-18）

作者(Author): 黄瑾瑾,杨宇石,孙紫君,范梦蕾,李翀瑶,薄莉,李小虎,徐澍
HUANG Jinjin,YANG Yushi,SUN Zijun,FAN Menglei,LI Chongyao,BO Li,LI Xiaohu,XU Shu

DOI: 10.19367/j.cnki.2096-8388.2022.03.006

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