目的:探讨肿瘤相关巨噬细胞(tumor associated macrophages,TAMs)标志物CD163和CD68蛋白在子宫内膜癌中的表达,分析其与子宫内膜癌患者临床病理特征及5年总生存率的相关性。方法:收集2010年1月-2015年12月在我院就诊的46例子宫内膜癌患者作为观察组,并以同期就诊的25例正常增生期子宫内膜患者作为对照组,采用免疫组织化学法检测两组患者的肿瘤相关巨噬细胞(TAMs)标志物CD163,CD68的表达水平,以TAMs计数的中位数为界,将子宫内膜癌病例分为CD163、CD68高表达组和低表达组,将CD163/CD68的比值以中位数为界分为CD163/CD68高比值组和低比值组,分析CD163,CD68的表达水平和CD163/CD68比值与子宫内膜癌患者临床病理参数及其预后的关系。结果:子宫内膜癌组织中CD163,CD68的表达水平均显著高于正常增生期子宫内膜患者(P<0.05)。CD163表达水平与病理分级、有无淋巴结转移和FIGO分期显著相关(P<0.05),CD68表达水平与肌层浸润深度和FIGO分期显著相关(P<0.05),CD163/CD68比值的高低与年龄、病理学分级、淋巴结转移和FIGO分期显著相关(P<0.05),CD163、CD68的表达及CD163/CD68比值与患者生存率无显著相关性(P>0.05),而淋巴结转移与患者的预后相关。结论:TAMs可能参与子宫内膜癌的发生发展,CD163和CD68的表达可能在子宫内膜癌的进展中起到重要的作用。
Purpose To investigate the expression of CD163,CD68 in endometrial cancer (EC)and its relation with the clinicopathological features and overall survival rate. Methods: A total of 46 EC tumors were collected from January 2010 to December 2015 in Changzhou Maternal and Child Health Care hospital affiliated to Nangjing Medical University as the experimental group, while contemporaneous 25 cases with benign endometrial diagnosed were selected as the control group. Immunhistochemistry was applied to detect the expressions of CD68, CD163 in the two groups. Taking the median expression level of tumor-associated macrophages (TAMs) as the cut-off value, experimental group was divided into high expression group and low expression group of CD68, CD163. The median ratio of CD163/CD68 was also taken as the cut-off value for CD163/ CD68 high ratio group and low ratio group. The relationship of their expressions and clinicopathological features and prognosis of endometrial cancer were analyzed.Results: The expression of CD163 and CD68 in endometrial cancer was significantly higher than that in control group. The expression of CD163 was associated with high pathological grade, high FIGO stage, lymph node metastasis. The expression of CD68 was associated with myometrial invasion, high FIGO stage. The ratio of CD163/CD68 was associated with high pathological grade, high FIGO stage, lymph node metastasis. Survival analysis found that there was no sigfnificant statistical difference in 5 year overall survival rate between the patients with the expression of CD163, CD68 and the ratio of CD163/CD68, Only lymph node metastasis was related to survival. Conclusion: TAMs may be involved in the development of uterine endometrial cancer. The expression of CD163 and CD68 may play an important role in the progression of EC.