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目的探讨早期宫颈癌转移与无转移时前哨淋巴结(sentinel lymph node,SLN)中树突状细胞(den-dritic cell,DC)表达的变化及临床意义。方法采用流式细胞技术,对2004年12月至2005年12月山西医科大学第一医院及山西省肿瘤医院的40例早期宫颈癌患者(Ⅰa2期5例,Ⅰb1期21例,Ⅰb2期11例,Ⅱa期3例)的前哨淋巴结中CD83、CD80、CD86的分布及表达进行检测,并与非前哨淋巴结的检测结果进行比较。结果树突状细胞CD83、CD80、CD86在有转移前哨淋巴结中的表达明显低于无转移的前哨淋巴结与非前哨淋巴结,无转移的前哨淋巴结中树突细胞的表达与无转移非前哨淋巴结的表达差异无显著性。结论前哨淋巴结肿瘤细胞转移后,改变了淋巴结的微环境,有功能成熟的CD83阳性树突细胞数量的减少且树突细胞共刺激因子CD80、CD86表达的下调可能是宫颈癌发生免疫逃逸的机制之一。无转移的前哨淋巴结及非前哨淋巴结存有正常免疫功能。
Objective To investigate the changes and clinical significance of dendritic cells (DCs) expression in sentinel lymph node (SLN) during the early stage of cervical cancer metastasis. Methods Forty cases of early stage cervical cancer from December 2004 to December 2005 in Shanxi Medical University and 40 cases of early cervical cancer (Ⅰa2 stage, 21 cases of stage Ⅰ b1, 11 cases of stage Ⅰ b2) were treated by flow cytometry , Ⅱ a period in 3 cases) sentinel lymph node CD83, CD80, CD86 distribution and expression were detected and compared with the non-sentinel lymph node test results. Results The expression of dendritic cells CD83, CD80 and CD86 in metastatic sentinel lymph nodes was significantly lower than that in non-metastatic sentinel lymph node and non-sentinel lymph node. The expression of dendritic cells in non-metastatic sentinel lymph node and non-metastatic non-sentinel lymph node No significant difference. Conclusion The metastasis of sentinel lymph node cells changes the microenvironment of lymph nodes. The number of mature CD83-positive dendritic cells decreases and the down-regulation of CD80 and CD86 expression may be the mechanism of immune escape in cervical cancer one. Non-metastatic sentinel lymph nodes and non-sentinel lymph nodes have normal immune function.