中文摘要：

目的 研究免疫微环境对不同部位巨噬细胞对鼻咽癌（NPC）进展和预后的影响。方法 收集在中山大学肿瘤防治中心经病理证实为鼻咽癌的石蜡标本557例。采用免疫组化染色法检测巨噬细胞分子标志物CD68,观察并计数CD68在癌巢和间质不同部位的表达,统计分析其阳性细胞数与临床病理特征及鼻咽癌患者预后的关系。结果 CD68^＋巨噬细胞在间质中浸润比癌巢中活跃（中位数：4.47/HPF相比1.87/HPF）。KaplanMeier生存曲线和log-rank统计分析结果表明,癌巢中的CD68^＋巨噬细胞数量与NPC患者的无瘤生存时间及总体生存时间均显著正相关。间质中的CD68^＋巨噬细胞数量与NPC患者的无瘤生存时间及总体生存时间亦显著正相关。单因素Cox比例风险模型显示,癌巢中的CD68^＋巨噬细胞浸润较多的患者相比于数量较少的患者发生治疗后转移复发（HR=0.667,P=0.002）及死亡（HR=0.626,P=0.002）的风险较低。间质中的CD68^＋巨噬细胞数量较多的患者较数量较少的患者发生治疗后转移复发（HR=0.664,P=0.005）及死亡（HR=0.66,P=0.008）的风险较低。结论 免疫微环境中癌巢和间质中CD68^＋巨噬细胞浸润数量增多与鼻咽癌患者预后呈正相关,CD68^＋巨噬细胞浸润数量增多可降低局部复发和远处转移风险。

英文摘要：

Objective This study was to investigate the influence of tmnor-associated macrophages on the progression and prognosis of nasopharyngeal carcinoma （NPC）. Methods 557 nasopharyngeal carcinoma paraffin specimens were collected in cancer center of Sun yat-sen university.Immunohistochemical staining method was used to detect macrophages molecular markers CD68, observe and count CD68 express numbers in nests and stroma, statistics are used to analyze the relationship between the positive cells from different parts with the clinical pathological characteristics and the prognosis of NPC patients. Results CD68^＋ macrophage infiltration in the stroma was more active than that in the nests （ median：4.47 / HPF： 1.87/HPF）. Kaplan-Meier survival curve and the log-rank statistical analysis results show that the number of CD68^＋ macrophages in nests had significant positive correlation with disease-free survival time and overall survival of NPC patients. The number of CD68^＋ macrophages in interstitial also had significant positive correlation with disease-free survival time and overall survival of NPC patients.Single factor Cox proportional hazards model shows that the recurrent transfer （HR= 0.667 ,P=0.667） and death （HR = 0. 626,P = 0. 626） risk is lower with the more infiltration of CD68^＋ macrophage in the nests than a small number of patients after treatment.More number of CD68^ maerophages in the stroma has lower recurrence of transfer （ HR =0.664,P=0.664） and death risk （ HR =0. 66,P=0.66） of patients after treatment in patients than a small number. Conclusion The number of CD68^＋ macrophages infiltration in the nests and stroma of the immune positively related with the prognosis of NPC patients, and it reduced the risk of local recurrence and distant metastasis. was