膀胱癌組織内の浸潤リンパ球の検討

Abstract

膀胱癌組織周囲の局所的な細胞性免疫能を検討する目的で, 121例の膀胱癌を対象としてリンパ球浸潤の度合と異型度, 深達度, 患者の予後との関係, さらに癌組織へ浸潤したリンパ球のsubset (T cell比, IgG FC receptor (+) T cell:Tγ cell比)を測定した.膀胱癌の異型度, 深達度とリンパ球の浸潤度の間には有意の相関を認めなかった.リンパ球浸潤度が低いほど, 再発例や死亡例が有意に増加した.膀胱癌患者の末梢血中T cell比, Tγ cell比は対照群と比べ, 前者で低く, 後者で有意に高かった.末梢血中と癌組織内のリンパ球について, T cell比は両者に有意差はなかったが, Tγ cell比は後者が有意に高かった.癌組織の基底部と表層部での浸潤リンパ球の分布は, T cell比は後者が有意に高く, Tγ cell比は前者で若干高値を示した.以上の結果から膀胱癌組織へのリンパ球浸潤の意義やリンパ球Subsetの機能による癌-宿主関係について考察を加えた

Using 121 patients with bladder cancer operated on at our institutes, the relationship between lymphocyte infiltration and grading, staging or patients' prognosis was studied for evaluating regional immunocompetence in bladder cancer. There was no correlation between number of infiltrating lymphocytes and tumor grading or staging. However, the patients with high grade or advanced stage showed high recurrence rate and mortality. The same tendency was observed in patients whose tumor had few infiltrating lymphocytes. A lymphocyte subset was detected in both peripheral blood and tumor extracts in 15 cases of bladder cancer. Compared with the normal controls, T cell percent was lower and T gamma cell ratio was higher in peripheral blood of bladder cancer patients. T cell percent was almost equal in peripheral blood and in cancer tissue, but the T gamma cell ratio in the cancer patients was much higher than that in blood. In the tumor tissues, high T cell and lower T gamma cell percentages were observed at basal areas than those at superficial portions. These results suggest that infiltrating lymphocytes may take part in the host response to the tumor in bladder cancer. Classification of these lymphocytes based upon function will be necessary for further study.