鼻腔鼻窦恶性黑色素瘤临床病理特征及其与肿瘤浸润淋巴细胞亚群的相关性

doi:10.16352/j.issn.1001-6325.2025.04.0527

基础医学与临床 ›› 2025, Vol. 45 ›› Issue (4): 527-531.doi: 10.16352/j.issn.1001-6325.2025.04.0527

鼻腔鼻窦恶性黑色素瘤临床病理特征及其与肿瘤浸润淋巴细胞亚群的相关性

王丽宁^1,2, 刘红刚^2*

1.北京市垂杨柳医院病理科,北京 100022;
2.首都医科大学附属北京同仁医院病理科, 北京 100005

收稿日期:2024-12-12 修回日期:2025-02-20 出版日期:2025-04-05 发布日期:2025-03-24
通讯作者: ^*liuhonggang@ccmu.edu.cn
基金资助:
北京市医管局扬帆计划重点医学专业—头颈部病理(ZYLX201814)

The clinical pathological characteristics of malignant melanoma in nasal cavity and paranasal sinuses and its correlation with subsets of tumor infiltrating lymphocytes

WANG Lining^1,2, LIU Honggang^2*

1. Department of Pathology, Beijing Chuiyangliu Hospital,Beijing 100022;
2. Department of Pathology, Beijing Tongren Hospital, Capital Medical University, Beijing 100005, China

Received:2024-12-12 Revised:2025-02-20 Online:2025-04-05 Published:2025-03-24

摘要/Abstract

摘要： 目的　总结鼻腔鼻窦恶性黑色素瘤(MMNS)的临床病理学特点,提出MMNS预后预测因子;观察并分析CD4、CD8、CD20的表达、定位以及其与预后的关系。方法　回顾分析87例MMNS患者临床病理资料,总结其临床病理特征;采用EnVision免疫组织化学(IHC)染色方法观察CD4、CD8、CD20在MMNS中的表达及定位情况。结果　87例MMNS患者中,男性46例,女性41例,年龄在43至81岁之间,中位年龄60岁。鼻腔合并鼻窦及周围组织浸润、肿瘤体积大及AJCC分期高则预后差(P＜0.05);统计结果显示性别、年龄、组织学类型、黑色素颗粒、核分裂象等与生存期之间无显著相关性(P＞0.05)。CD4⁺、CD8⁺及CD20⁺肿瘤浸润淋巴细胞(TILs)免疫亚型在瘤内间质与肿瘤基底分组之间差异均有统计学意义(P＜0.05),且瘤内间质CD4⁺、CD8⁺及CD20⁺TILs的阳性计数的高低与肿瘤基底部TILs密度呈正相关(P＜0.01)。不管是瘤内间质还是肿瘤基底部CD20⁺B细胞与CD4⁺、CD8⁺T细胞分布于同一区域,为较均匀的掺杂分布,CD20⁺B细胞没有中心聚集形成三级淋巴结构的趋势。不同亚型分组的总生存期之间的差异无统计学意义。结论　不论是瘤内间质还是肿瘤基底部间质,CD20⁺B细胞的数量均明显少于CD4⁺、CD8⁺T细胞,不能形成三级淋巴结构,与皮肤恶性黑色素瘤不同,可能是MMNS预后差的一个原因。

关键词: 鼻腔鼻窦黏膜黑色素瘤, 肿瘤浸润淋巴细胞, CD4, CD8, CD20

Abstract: Objective To identify independent predictors of prognosis in MMNS and to examine the expression of CD4, CD8, CD20 and their relationship with prognosis. Methods 87 patients with MMNS were retrospectively analyzed to summarize their clinicopathologic characteristics; the expression of CD4, CD8, and CD20 in MMNS were observed by EnVision immunohistochemical staining (IHC) to analyze the relationship between the expression of these markers and prognosis. Results MMNS with sinus, surrounding tissue invasion, larger tumor and higher AJCC stage showed a worse prognosis. No significant correlation was found among sex, age, histological type,melanin granules, mitotic figures and survival rate. The counts of CD4⁺, CD8⁺ and CD20⁺ TILs in intra-tumoral stroma were positively correlated with the density of TILs at the base of the tumor. CD20⁺ B cells did not have a central tendency to aggregate to form tertiary lymphoid structures, whether in the intratumoral stroma or in the basal stroma of the tumor, the three cell subsets were admixed. There was no statistically significant difference in OS between CD4⁺, CD8⁺, and CD20⁺ subsets. Conclusions The number of CD20⁺ B cells was significantly less than that of CD4⁺ and CD8⁺ T cells in both the intratumoral stroma and the basal stroma of the tumor, and tertiary lymphoid structures fail to be formed, which, unlike cutaneous malignant melanoma, might be a cause of the poor prognosis of MMNS.

Key words: malignant melanoma in nasal cavity and paranasal sinuses, tumor infiltrating lymphocytes, CD4, CD8, CD20

中图分类号:

王丽宁, 刘红刚. 鼻腔鼻窦恶性黑色素瘤临床病理特征及其与肿瘤浸润淋巴细胞亚群的相关性[J]. 基础医学与临床, 2025, 45(4): 527-531.

WANG Lining, LIU Honggang. The clinical pathological characteristics of malignant melanoma in nasal cavity and paranasal sinuses and its correlation with subsets of tumor infiltrating lymphocytes[J]. Basic & Clinical Medicine, 2025, 45(4): 527-531.

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鼻腔鼻窦恶性黑色素瘤临床病理特征及其与肿瘤浸润淋巴细胞亚群的相关性

The clinical pathological characteristics of malignant melanoma in nasal cavity and paranasal sinuses and its correlation with subsets of tumor infiltrating lymphocytes

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