杨帆;宋斌;宋多;窦小亮;

• 1:中国人民解放军空军军医大学第二附属医院泌尿外科

摘要(Abstract)：

目的探讨肾肿瘤患者肿瘤微环境中T细胞亚群与其病理参数的相关性。方法选取2016年12月至2017年12月本院收治的84例行择期手术治疗的肾肿瘤患者,检测肿瘤组织中不同T细胞亚群的表达水平,并对其表达水平与病理分期及相关参数间的相关性进行分析。结果随着临床分期的增加CD4+T细胞和调节性T细胞占比呈上升趋势(均P <0.05),而CD8+T细胞占比则显著降低(P <0.05)。调节性T细胞在高、中、低分化患者中占比逐渐升高(P=0.02)。合并淋巴结转移的患者CD4+T细胞和调节性T细胞表达水平升高(P <0.05),而CD8+T细胞表达水平降低(P <0.05)。结论肿瘤组织中T细胞亚群表达水平失衡与肿瘤细胞的分化、分期和转移相关,调节T细胞亚群表达水平或可改善患者临床预后。

关键词(KeyWords)： 肾肿瘤;肿瘤微环境;T细胞;临床分期;转移

Abstract:

Keywords:

基金项目(Foundation):

作者(Authors): 杨帆;宋斌;宋多;窦小亮;

参考文献(References)：

• [1]Laguna MP.Re:Renal Tumor Biopsy for Small Renal Masses:A Single-Center 13-Year Experience[J].J Urol,2016,195(5):1378-1379.
• [2]鲍磊．后腹腔镜下肾部分切除术治疗肾肿瘤的疗效分析[J]．中国实用医药，2016,11(2):83-84．
• [3]Snarskis C,Calaway AC,Wang L,et al.Standardized Reporting of Microscopic Renal Tumor Margins:Introduction of the Renal Tumor Capsule Invasion(i-Cap)Scoring System[J].JUrol,2017,197(1):23-30.
• [4]Haussler MR,Whitfield GK,Haussler CA,et al.1,25-Dihydroxyvitamin D and Klotho:A Tale of Two Renal Hormones Coming of Age[J].Vitam Horm,2016,100:165-230.
• [5]Kim KJ,Lee KS,Cho HJ,et al.Prognostic implications of tumor-infiltrating Fox P3+regulatory T cells and CD8+cytotoxic T cells in microsatellite-unstable gastric cancers[J].Hum Pathol,2014,45(2):285-293.
• [6]Eckl J,Buchner A,Prinz PU,et al.Transcript signature predicts tissue NK cell content and defines renal cell carcinoma subgro ups independent of TNM staging[J].J Mol Med(Berl),2012,90(1):55-66.
• [7]Mir MC,Derweesh I,Porpiglia F,et al.Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors:A Systematic Review and Meta-analysis of Comparative Studies[J].Eur Urol,2017,71(4):606-617.
• [8]Shah PH,Moreira DM,Okhunov Z,et al.Positive Surgical Margins Increase Risk of Recurrence after Partial Nephrectomy for High Risk Renal Tumors[J].J Urol,2016,196(2):327-234.
• [9]王倩，肖文华．肿瘤来源外泌体在机体免疫系统与肿瘤微环境中的作用及其临床应用前景[J]．解放军医学院学报，2017,38(1):71-74．
• [10]Schietinger A,Philip M,Krisnawan VE,et al.Tumor-Specific TCell Dysfunction Is a Dynamic Antigen-Driven Differentiation Program Initiated Early during Tumorigenesis[J].Immunity,2016,45(2):389-401.
• [11]黄韬，龙兆麟，吴世皓，等．PD-1/PD-L1在膀胱癌患者外周血T细胞和肿瘤细胞表达[J]．中山大学学报（医学科学版），2017,38(4):628-631．
• [12]Mac Farlane AW,Jillab M,Plimack ER,et al.PD-1 expression on peripheral blood cells increases with stage in renal cell carcinoma patients and is rapidly reduced after surgical tumor resection[J].Cancer Immunol Res,2014,2(4):320-331.
• [13]Nirschl CJ,Drake CG.Molecular pathways:coexpression of immune checkpoint molecules:signaling pathways and implications for cancer immunotherapy[J].Clin Cancer Res,2013,19(18):4917-4924.
• [14]刘伟，刘任功，罗辉，等．监测肾癌患者外周血CD4+CD25+调节性T细胞在术后免疫治疗中的作用[J]．现代肿瘤医学，2012,20(8):1649-1652．
• [15]Peng W,Chen JQ,Liu C,et al.Loss of PTEN Promotes Resistance to T Cell-Mediated Immunotherapy[J].Cancer Discov,2016,6(2):202-216.
• [16]Sakai S,Kauffman KD,Sallin MA,et al.CD4 T CellDerived IFN-γPlays a Minimal Role in Control of Pulmonary Mycobacterium tuberculosis Infection and Must Be Actively Repressed by PD-1 to Prevent Lethal Disease[J].PLo S Pathog,2016,12(5):e1005667.