腎細胞癌における腫瘍浸潤性単球系細胞の臨床的検討

Abstract

腎摘出術を施行した腎細胞癌78例(男58例・女20例)を対象に, 腎細胞癌組織中の腫瘍関連マクロファージ(TAM)と樹状細胞(DC)について, 腫瘍組織中のTAM・DCの予後への影響, TAMと癌組織中における血管新生・癌細胞増殖能・癌細胞のアポトーシスとの相互関連, 既存予後因子とTAM, DCとの関連に関し免疫組織学的解析を行い, 臨床的意義を検討した.腎細胞癌においてTAM数とMVDが正の相関をすることと, TAM高値群が予後不良であることが判明した.癌細胞の血管新生については, 腫瘍産生血管新生促進因子とTAM産生血管新生促進因子が推定されている

To investigate the relationship between the ratio of monocytes infiltrating renal cell carcinoma (RCC) and prognosis, in 78 patients who underwent nephrectomy, the positive rate of the following parameters was assessed immunohistochemically under light microscopy: tumor-associated macrophage (TAM), microvessel density (MVD), S-100 cell, HLA-DR cell, apoptosis index (AI) and proliferative index (PI). The relationship between the positive rate of these parameters and prognosis, and intercorrelations among these parameters were analyzed. A positive correlation with prognosis was observed in patients positive for TAM, MVD or PI (r = 0.625). Prognosis was poor for patients with high levels of these parameters. Furthermore, the number of S-100-positive cells was a prognostic factor only in patients with metastatic RCC. Although the role of TAM as a prognostic factor in RCC is clear, no linear relationship was identified between prognosis and other monocytes.