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目的研究自然杀伤细胞(NK细胞)浸润与肝细胞癌临床病理特征的关系,探讨其对肝癌预后的影响。方法选取2002年1月至2006年12月上海交通大学医学院附属第三人民医院240位肝细胞癌患者的标本制成组织芯片并用CD57作为NK细胞的标记物进行免疫组化染色,判断癌组织内NK细胞浸润情况,分析NK细胞浸润与预后的关系。结果癌组织内NK细胞浸润数高低与临床病理特征无统计学联系,浸润高组的总体生存率高于低组(3年生存率分别为62%和46%,P=0.018),两组间的无瘤生存率无统计学差异(P=0.102)。癌组织内NK细胞浸润数是总体生存率的独立预后因素(P=0.010)。尤其对于癌栓阳性组患者,癌组织内NK细胞浸润高、低两组间的中位无瘤生存时间(P=0.013)和中位生存时间(P=0.009)差异均有统计学意义。结论肝细胞癌组织内浸润的自然杀伤细胞对肝癌切除术后具有保护作用,这种作用对癌栓阳性患者意义更大。
Objective To study the relationship between natural killer cell (NK) infiltration and clinicopathological features of hepatocellular carcinoma (HCC), and to explore its effect on the prognosis of HCC. Methods From January 2002 to December 2006, 240 hepatocellular carcinoma patients from the Third People ’s Hospital Affiliated to Shanghai Jiao Tong University School of Medicine were made into tissue microarray and CD57 was used as a marker of NK cells to detect the expression of cancer tissue NK cell infiltration, analysis of NK cell infiltration and prognosis. Results There was no significant correlation between the number of NK cell infiltration and the clinicopathological features in the cancerous tissue. The overall survival rate of the infiltrated high group was higher than that of the low group (3-year survival rates were 62% and 46%, respectively, P = 0.018) The tumor-free survival rate was no significant difference (P = 0.102). The number of NK cell infiltrates in cancer tissues was an independent prognostic factor for overall survival (P = 0.010). Especially for patients with tumor thrombus positive, there was significant difference in the median tumor-free survival time (P = 0.013) and median survival time (P = 0.009) between the two groups with high NK cell infiltration in the cancer tissues. Conclusion The natural killer cells infiltrating into hepatocellular carcinoma have a protective effect after resection of hepatocellular carcinoma. This effect is more significant for patients with positive tumor embolus.