Correlation And Influencing Factors Between Clinicopathological Features Of Prostate Cancer And Tumor-associated Macrophages

Objective:Recent years,tumor-associated macrophages(TAMs)have been considered to be extremely important in the development and treatment of prostate cancer(PCa).This study analyze the correlation between tumor-associated macrophages(TAMS)and TNM stage,risk rating and Gleason score of PCa.To further speculate the role of TAMs in prognosis assessment of prostate cancer,and speculate its role in the development of prostate cancer.Methods:A total of 47patients dignosed with PCa from the The First Affiliated Hospital of Soochow University from January 2019 to December 2019 who confirmed by transrectal ultrasound(TRUS)-guided prostate biopsy and underwent radical prostatectomy were selected.Formalin-fixed tissues obtained from these patients were treated by immunofluorescence staining.10-15 high magnification field of views(400x)were randomly took.We assessed the number of macrophage cells(CD68+),M1 macrophages(CD68+,MCP-1 receptor+),and M2 macrophages(CD68+,CD206+)in adjacent tissues and tumor tissues.The clinical data of the patients,including age,BMI,PSA,TNM staging,Gleason score,anti-androgenic therapy(taking at least 3 months before prostate biopsy)were collected.And all data were statistically analyzed using SPSS 26.0.Results:1.TNM staging and Risk rating were positively correlated with the infiltration of CD68+macrophages,M1,M2 macrophages and proportion of M2 macrophages both in tumor and adjacent tissues(rs>0.3,P<0.01).The proportion of M1 macrophages(TM1/TM),the ratio of M1 and M2(TM1/TM2)in the tumor tissue,and the ratio of M1,M2(NM1/NM2)in adjacent tissues were negatively correlated(rs<-0.3,P<0.05);No significant correlation with the proportion of M1 macrophages(NM1/NM)was found in the adjacent tissues(rs=-0.195,P=0.108>0.05).2.Gleason score was positively correlated with the infiltration of CD68+macrophages,M2 macrophages both in tumor and adjacent tissues(rs>0.3,P<0.01).A lower proportion of M1 macrophage and a smaller ratio of M1 and M2 suggested a higher level of Gleason score(rs<-0.6,P<0.05).No significant relationship between the infiltration of Ml macrophages(NM1)and Gleason score was found in the adjacent tissues(rs=0.152,P=0.308>0.05)..3.Anti androgenic therapy such as taking finasteride was negatively correlated with the infiltration of M2 macrophages in the tumor(95%CI,0.004?0.056,P<0.05),and there was no significant correlation with the number of Ml and M2 macrophage infiltration.4.The age of patients was negatively correlated with the proportion of M1 macrophages(TM1/TM)in tumor tissue(rs=-0.318,P<0.05)and ratio of M1/M2 macrophage(NM1/NM2)in adjacent tissues(r=-0.36,P<0.05);In contrast,the proportion of M2 macrophages(NM2/NM)in the adjacent tissues(r=0.4,P<0.01)was positively correlated.No significant correlation was found with other data(| r |<0.3,P>0.05).The current data sample size was not sufficient to illustrate the relationship between TAMs and tPSA,prostate volume,and BMI(|r|<0.3,P>0.05).5.CD68+macrophage infiltrate adjacent tissue to a higher level than those of adenocarcinoma.(99%CI:-19.39612?-16.18898,-8.36311?-7.21434,-8.49627?-18.358,P<0.001).Conclusions:1)TAM infiltration may be related to the malignancy and prognosis of prostate cancer;particularly that higher proportion of M2 macrophage may contributes to higher degree of malignancy and worse differentiation;2)Anti androgenic therapy may reduce the proportion of M2 macrophages in the tumor,which may have a potential benign effect on the treatment of prostate cancer;3)Ratio of NM1/NM2 macrophage gets smaller and NM2/NM gets higher as the patient gets older,which may be more likely to cause poor prognosis.tPSA,prostate volume,and height and BMI had no significant correlation with the TAM;4)M2 were the main macrophage in prostate cancer.Differences exist in the distribution of TAM between the lesion and surrounding normal prostate tissue in prostate cancer patients.