人巨细胞病毒感染对围手术期尿路上皮癌患者免疫功能的影响  

Impact of Human Cytomegalovirus Infection on Immune Function of Urothelial Carcinoma Patients in Perioperative Period

作　　者：李法锦[1,2] 施浩强[3] 唐亮[3] 张涛[4] 樊松[3] 江长琴[3] 葛俊[1] 王明丽[1] 梁朝朝[3] 

机构地区：[1]安徽医科大学微生物教研室,合肥230022 [2]贵州省疾病预防控制中心传染病防治研究所检验科,贵阳550004 [3]安徽医科大学第一附属医院泌尿外科 [4]安徽医科大学第二附属医院泌尿外科

出　　处：《肿瘤防治研究》2014年第2期119-123,共5页Cancer Research on Prevention and Treatment

基　　金：国家临床重点专科(泌尿外科)建设项目

摘　　要：目的检测围手术期尿路上皮癌患者外周血的CD3+、CD4+、CD8+T淋巴细胞比例和人类巨细胞病毒(HCMV)IgG和IgM抗体,了解近期HCMV感染对围手术期尿路上皮癌患者细胞免疫功能的影响。方法采集33例经病理检测确诊为尿路上皮癌的患者外周血,流式细胞仪检测外周血CD3+、CD4+和CD8+T细胞亚群比例,血浆ELISA法定性检测HCMV-IgG和HCMV-IgM抗体,根据HCMV-IgM抗体结果将尿路上皮癌患者分为阳性组和阴性组,比较两组患者的T细胞亚群有无差异。结果 33例患者中HCMV-IgG抗体阳性31例;HCMV-IgM抗体阳性7例,阴性26例。HCMV-IgM阳性组和阴性组之间的CD3+、CD4+和CD8+T细胞亚群有着显著的差异(P<0.01)。阳性组患者的CD4+T细胞的百分比显著低于阴性组,并且该组CD4+/CD8+比值亦显著低于阴性组。CD4+/CD8+的比值提示阳性组中有85%(6/7)的患者处于免疫功能低下状态,而相对于阴性组仅有11.5%(3/23)的患者处于免疫功能低下状态,两组间差异有统计学意义(P<0.01)。结论术前检测HCMV-IgM可以很好地预测尿路上皮癌患者的细胞免疫功能,对术后辅助治疗具有指导意义。Objective To detect the ratio of CD3+, CD4+, CD8+ T lymphocytes and HCMV-IgG and IgM antibodies in peripheral blood of urothelial carcinoma patients in perioperative period and to evaluate the impact of HCMV infection on immune functions. Methods Thirty-three peripheral blood samples were collected from urothelial carcinoma patients with pathological diagnosis. Flow cytometry was performed to detect the ratio of CD3+, CD4+ and CD8+ T lymphocytes subsets. ELISA was conducted to detect HCMVIgG and IgM antibodies. Patients were divided into positive group and negative group based on HCMVIgM results. T lymphocyte difference was also compared. Results HCMV-IgG antibodies of 31 patients were positively expressed, HCMV-IgM antibodies of 7 patients were positively expressed, and HCMV-IgM antibodies of 26 patients were negatively expressed respectively. CD3+, CD4+ and CD8+ T lymphocytes subsets were statistically different between HCMV-IgM positive and negative groups(P<0.01). The percentage of CD4+ T lymphocytes and CD4+/CD8+ ratio of positive group were obviously less than those of negative group. CD4+/CD8+ ratio showed that the immune function of 85%(6/7) positive group was poor, while there was only 11.5%(3/23) in negative group. There was a statistical difference between two groups(P<0.01). Conclusion Detecting HCMV-IgM preoperatively may predict the cellular immune functions of patients with urothelial carcinoma, contributing to perform adjuvant therapy after operation.

关 键 词：尿路上皮癌 人巨细胞病毒 细胞免疫 

分 类 号：R737.14[医药卫生—肿瘤]