实用医学杂志 ›› 2021, Vol. 37 ›› Issue (12): 1549-1553.doi: 10.3969/j.issn.1006⁃5725.2021.12.008

• 临床研究 • 上一篇    下一篇

CAⅨ联合CD8+TIL对宫颈癌淋巴结转移的预测价值

杨杨, 梁罗娇, 周琛斐, 陈晓静, 王薇    

  1. 广州医科大学附属第一医院妇产科(广州 510120)

  • 出版日期:2021-06-25 发布日期:2021-06-25
  • 通讯作者: 王薇 E⁃mail:smugowwang@126.com
  • 基金资助:

    国家自然科学基金资助项目(编号:81672589 81971341);中国博士后科学面上基金项目(编号:2019M662868 

Predictive value of CAⅨ combined with CD8 + TIL for lymph node metastasis of cervical cancer

YANG Yang,LIANG Luojiao,ZHOU Chenfei,CHEN Xiaojing,WANG Wei.    

  1. Department of Obstetrics and Gynecology,the First Affiliated Hospital of Guangzhou Medical University,Guangzhou 510120,China 

  • Online:2021-06-25 Published:2021-06-25
  • Contact: WANG Wei E⁃mail:smugowwang@126.com

摘要:

目的 探讨宫颈癌组织中碳酸酐酶Ⅸ(carbonicanhydraseⅨ,CAⅨ)及 CD8+ 肿瘤浸润淋巴细 胞(tumorinfiltratinglymphocytes,TIL)的表达与淋巴结转移的相关性,以及联合检测对淋巴结转移的临床预测价值。 采用免疫组化法检测 75 例手术切除的宫颈癌组织中 CAⅨ CD8+ TIL 的表达分布水平,运用统计学方法分析两者与患者临床病理特征的相关性,及对淋巴结转移的预测效能。结果 宫颈癌组织 中,CAⅨ的表达与癌巢 CD8+ TIL 数量呈负相关(P < 0.001),与间质 CD8+ TIL 数量呈正相关(P < 0.001)。同时,CAⅨ高低表达与淋巴结转移(P = 0.002)相关。CAⅨ的表达随淋巴结转移而升高(P = 0.001),癌巢 CD8+ TIL 数量随淋巴结转移而减少(P < 0.001),CAⅨ联合癌巢 CD8+ TIL 预测淋巴结转移的曲线下面积 areaundercurve,AUC)(0.837,P < 0.001)、特异度(100%)、阳性预测值(100%)、准确度(85.3%)高于联合 间质 CD8+ TIL 及单独 CAⅨ的检测。结论 缺氧可能参与 CD8+ TIL 的调控,缺氧、癌巢 CD8+ TIL 可能与宫颈癌淋巴结转移密切相关,CAⅨ联合癌巢 CD8+TIL 检测可作为宫颈癌淋巴结转移的预测因素,减少淋巴结 转移的误诊。

关键词:

宫颈癌, 缺氧, 碳酸酐酶, CD8+ 肿瘤浸润淋巴细胞, 淋巴结转移

Abstract:

Objective To analyze the correlation between the expression levels of carbonic anhydrase Ⅸ (CAⅨ)and CD8+ tumor infiltrating lymphocytes(TIL)and lymph node metastasis(LNM)in cervical cancer(CC), and evaluate the clinical predictive value of CAIX combined with CD8 + TIL for LNM. Methods The expression levels and distribution patterns of CAIX and CD8 + TIL in 75 samples of CC by surgical resection were detected by immunohistochemical staining. The correlation between the two parameters and clinicopathological features of patients was statistically analyzed. The predictive efficacy of them for LNM was also assessed. Results The expres⁃ sion of CAⅨ was negatively correlated with the number of intraepithelial CD8+ TIL(P < 0.001),whereas positively correlated with the number of stromal CD8 + TIL(P < 0.001).The expression of CAⅨ was significantly correlated with LNM(P = 0.002). The expression of CAⅨ was significantly up⁃regulated with LNM(P = 0.001),whereas the number of intraepithelial CD8+ TIL was significantly decreased with LNM(P < 0.001). The area under curve of CA Ⅸ combined with intraepithelial CD8+ TIL for predicting LNM(0.837,P < 0.001),specificity(100%),positive pre⁃ dictive value(100%)and accuracy(85.3%)were higher compared with those of CAⅨ combined with stromal CD8+ TIL and CAⅨ alone. Conclusion Hypoxia is probably involved in the regulation of CD8 + TIL. Hypoxia and in⁃ traepithelial CD8+ TIL may be closely associated with LNM is in CC. Combined detection of CAⅨ and intraepithelial CD8+ TIL could serve as a predictor for LNM in CC and reduce the misdiagnosis of LNM. 

Key words:

cervical cancer, hypoxia, carbonic anhydrase Ⅸ, CD8+ tumor infiltrating lymphocytes, lymph node metastasis