浆细胞样树突状细胞与进展期胃癌淋巴结转移的相关性研究

doi:10.19401/j.cnki.1007-3639.2025.08.008

摘要/Abstract

摘要：

背景与目的：浆细胞样树突状细胞是肿瘤微环境（tumor microenvironment，TME）中的关键免疫细胞之一，可以通过直接或间接的方式调控肿瘤相关免疫应答，在肿瘤的发展及转移过程中发挥着多重影响。本研究旨在探讨进展期胃癌患者淋巴结中浆细胞样树突状细胞与淋巴结转移的相关性。方法： 收集2019年1月—2023年12月，在丹东市第一医院普外一科因胃癌首次接受手术治疗的进展期胃癌患者的术后淋巴结组织标本及临床病理学资料，并根据病理学分期和转移淋巴结直径将淋巴结分组。本研究经丹东市第一医院医学伦理委员会批准（DDSDYYY-LLSC-2025-02-18-019-01），并获得患者知情同意。采用免疫组织化学染色的方法，检测不同分组淋巴结中CD123阳性浆细胞样树突状细胞的丰度，进一步分析其与进展期胃癌淋巴结转移的相关性。结果： 纳入本研究的116例胃癌患者的淋巴结组织中存在浆细胞样树突状细胞的浸润。随着分化程度降低、pT分期和病理学分期的升高，以及脉管和神经的侵犯，转移淋巴结组织中的CD123阳性浆细胞样树突状细胞平均数量显著增多，差异有统计学意义（P<0.05）。转移淋巴结阳性组织内CD123阳性浆细胞样树突状细胞数量多于转移淋巴结阴性的组织；pN1-3分期的宏转移淋巴结组多于微转移组；pN1-3分期的未转移淋巴结组多于pN0分期淋巴结组，差异有统计学意义（P<0.05）。淋巴结转移阳性的病例中，2站淋巴结内CD123阳性浆细胞样树突状细胞数量多于1站（P<0.05）。结论： 进展期胃癌患者淋巴结中CD123阳性浆细胞样树突状细胞的浸润与胃癌淋巴结转移具有密切的相关性，可能是胃癌淋巴结转移的前提条件。了解CD123阳性浆细胞样树突状细胞在胃癌患者淋巴结中的分布情况，有助于进一步探讨其在胃癌免疫微环境中的作用机制。以CD123阳性浆细胞样树突状细胞为目标的靶向治疗，有望成为能进展期胃癌治疗的新思路。

关键词: 浆细胞样树突状细胞, CD123, 进展期胃癌, 淋巴结转移, pTNM分期

Abstract:

Background and purpose: Plasmacytoid dendritic cells are one of the key immune cells in the tumor microenvironment (TME), which can directly or indirectly regulate tumor related immune responses and play multiple roles in the development and metastasis of tumors. This study aimed to investigate the correlation between plasmacytoid dendritic cells in lymph nodes and lymph node metastasis in patients with advanced gastric cancer. Methods: Postoperative lymph node tissue specimens and clinicopathological data from advanced gastric cancer patients who underwent D2 radical surgery in the Department of General Surgery at the First Hospital of Dandong were gathered from January 2019 to December 2023. The lymph nodes were grouped based on pTNM staging and the diameter of metastatic lesions. This study was approved by the Medical Ethics Committee of Dandong First Hospital (No. DDSDYYY-LLSC-2025-02-18-019-01), and all patients signed informed consents. Immunohistochemical staining was used to detect the expression levels of CD123-positive plasmacytoid dendritic cells in different lymph node groups, and their correlation with lymph node metastasis in advanced gastric cancer was further analyzed. Results: Of the 116 patients, plasmacytoid dendritic cells infiltrate the lymph node tissues of gastric cancer patients. As tumor differentiation decreased and pT stage, pathological stage, lymphatic/vascular invasion, and perineural invasion increased, the mean number of CD123-positive pDC in metastatic lymph nodes rose significantly (P<0.05). The number of CD123-positive plasmacytoid dendritic cells was higher in metastatic lymph node-positive tissues than in metastatic lymph node-negative tissues, the number was higher in the macrometastasis group of pN1-3 staging than in the micrometastasis group, and the number was higher in the non-metastatic lymph node group of pN1-3 staging than in the pN0 staging lymph node group (P<0.05). In lymph node metastasis-positive cases, the number of CD123-positive plasmacytoid dendritic cells was higher in second-station lymph nodes than in first-station lymph nodes (P<0.05). Conclusion: The infiltration of CD123-positive plasmacytoid dendritic cells in lymph nodes of patients with advanced gastric cancer is closely associated with lymph node metastasis and may serve as a prerequisite for metastatic spread. Understanding the distribution of CD123-positive plasmacytoid dendritic cells in gastric cancer lymph nodes can help further explore their role in the immune microenvironment of gastric cancer. Targeted therapy focusing on CD123-positive plasmacytoid dendritic cells may become a new strategy for the treatment of advanced gastric cancer.

Key words: Plasmacytoid dendritic cell, CD123, Advanced gastric cancer, Lymph node metastasis, pTNM staging

中图分类号:

R735.2

陈战伟, 吴瑶强, 王彦平, 张德健, 于福翔. 浆细胞样树突状细胞与进展期胃癌淋巴结转移的相关性研究[J]. 中国癌症杂志, 2025, 35(8): 792-798.

CHEN Zhanwei, WU Yaoqiang, WANG Yanping, ZHANG Dejian, YU Fuxiang. A study on the correlation between plasmacytoid dendritic cells and lymph node metastasis in advanced gastric cancer[J]. China Oncology, 2025, 35(8): 792-798.

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Clinical characteristics	Number of cases	Group A (n=44)	Group B (n=72)	χ² value	P value
Gender
Male	78	28 (35.9)	50 (64.1)	0.418	0.518
Female	38	16 (42.1)	22 (57.9)
Age/year
≥65	74	30 (40.5)	44 (59.5)	0.591	0.442
<65	42	14 (33.3)	28 (66.7)
Tumor diameter/cm
≥5	60	16 (26.7)	44 (73.3)	6.698	0.010
<5	56	28 (50.0)	28 (50.0)
Degree of differentiation
Well + moderately	50	27 (54.0)	23 (46.0)	9.638	0.002
Poorly	66	17 (25.8)	49 (74.2)
Vascular invasion
+	58	2 (3.4)	56 (96.6)	-	0.001
-	58	42 (72.4)	16 (27.6)
Perineural invasion
+	32	0 (0.0)	32 (100.0)	-	0.001
-	84	44 (52.4)	40 (47.6)
pT stage
T1+T2	41	24 (58.5)	17 (41.5)	11.436	0.001
T3+T4	75	20 (26.7)	55 (73.3)
Pathological staging
Ⅰ+Ⅱ	66	44 (66.7)	22 (33.3)	-	0.001
Ⅲ+Ⅳ	50	0 (0.0)	50 (100.0)

Clinical characteristics	Number of cases	Number of pDCs	t/t’	P value
Gender
Male	52	43.45±6..62	1.361	0.178
Female	20	45.72±5.48
Age/year
≥65	46	43.67±6.58	0.557	0.579
<65	26	44.56±6.07
Tumor diameter/cm
≥5	14	43.54±6.82	0.840	0.404
<5	58	45.07±5.70
Degree of differentiation
Well+moderatel	23	40.17±5.72	3.784	0.001
Poorly	49	45.83±6.53
Vascular invasion
+	56	45.73±6.31	5.784	0.001
-	16	36.19±4.47
Perineural invasion
+	32	47.56±5.73	4.983	0.001
-	40	40.82±5.72
pT stage
T1+T2	17	35.44±2.85	8.283	0.001
T3+T4	55	45.70±5.96
Pathological staging
Ⅰ+Ⅱ	22	35.68±3.18	9.127	0.001
Ⅲ+Ⅳ	50	46.38±5.14