Nghiên cứu đặc điểm giải phẫu bệnh và một số tế bào miễn dịch trong vi môi trường ung thư biểu mô đại trực tràng được phẫu thuật tại Bệnh viện Trung ương Quân đội 108

Abstract

Objective: To consider histopathological characteristics of colorectal carcinoma according to WHO 2010 classification. To identify the number of T lymphocytes (CD4, CD8 positive cells) and macrophages (CD68 positive cells) in colorectal adenocarinoma microenvirement by Immunohistochemmistry and compare with some histopathological characteristics. Subject and method: Study on 127 patients with colorectal carcinoma (Icncluding 50 patients with adenocarrcinoma stainned Imumnohistochemistry) diagnosed at the 108 Military Central Hospital from October 2018 to July 2019. Result: Tumors were mainly found in the rectum (29.9%). Adenocarcinoma occursed in 85.8% of cases (Moderately differentiated adenocarcinoma was 84.4%), 45.7% of cases had serosal invasion; lymph node metastasis is 31.5%. High density of CD8 positive cells in tumor cell nest and in tumor stroma was more common in men than in women. Conversely, high density of CD4 positive cells in tumor cell nest was higher in men than in women. At stage of T1-T2, high density of CD4 and CD68 positive cells were common in tumor stroma, meanwhile high density of CD68 positive cells infiltrated only in tumor cell nests.  At stage of
T3-T4, low density of CD8 and CD68 positive cells was more common in the tumor stroma; low density of CD68 positive cells in tumor cell nest was dominated. Low density of infitration of CD68 positive cells were often seen both in the tumor stroma and tumor matrix if lymph node metastases occurred. If there are no lymph node metastasis, high density of CD68 positive cells infiltrates both the tumor stroma and the tumor cell nest. Differences in the correlations between CD4, CD8 and CD68 positive cells with histological grade, tumor gross morphology, tumor location and age group were not statistically significant. Conclusion: Tumor was located mainly in the rectum and histopathology was moderately differentiated adenocarcinoma. The rates of serosal invasion and lymph node metastases were 45.7% and 31.5%, respectively. High density of CD4, CD8 positive cells were more common in men than in women and high density of CD68 positive cells was more common in stage of T1-T2 than T3-T4. Low density of CD68 positive cell was more often seen in cases of lympho node metastasis.