初治鼻咽癌患者的细胞免疫功能和检测指标的评价  

Cellular immunity status of untreated patients with nasopharyngeal carcinoma and evaluation of examining parameters

作　　者：张玉晶[1] 陈育标[2] 夏云飞[1] 刘秀芳[1] 刘慧[1] 卢泰祥[1] 

机构地区：[1]中山大学肿瘤防治中心放射治疗科,广州510060 [2]广东省揭阳市人民医院放射治疗科

出　　处：《中国肿瘤临床与康复》2004年第6期481-484,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的　检测初治鼻咽癌患者疗前的多项细胞免疫指标 ,判断其细胞免疫功能状态 ,比较不同检测指标的准确性。方法　 2 0 0 3年 3月～ 2 0 0 3年 12月收治鼻咽癌患者 10 5例 ,疗前抽取晨起空腹外周静脉血 ,流式细胞术检查其T淋巴细胞亚群、T细胞活化水平、B细胞和NK细胞比例 ,3H TdR释放法检测LAK活性 ,并结合肿瘤的临床分期和乙肝两对半检查 ,研究各指标之间的相关关系。结果　根据 1992年福州分期 ,Ⅰ期 6例 ,Ⅱ期 2 1例 ,Ⅲ期 4 8例 ,Ⅳa期 30例。所有患者的BUN、Cr均大致正常 ,且排除HIV感染。CD8与病期有显著相关 (r =0 .2 18,P =0 .0 13) ;与病期有接近显著相关关系的指标有CD4 CD8比值 (P =0 .0 5 1)、CD8+ CD2 5 + 细胞 (P =0 .0 5 9)和LAK细胞活性 (P =0 .0 5 7)。患者的临床病期与HBsAg阳性有显著相关关系 (r=0 .2 2 0 ,P =0 .0 12 )。排除HBV因素后与病期有显著相关关系的指标有CD4 (r =- 0 .2 5 3,P =0 .0 2 5 )、CD8(r =0 .2 84 ,P =0 .0 13)、CD4 CD8比值 (r =- 0 .346 ,P =0 .0 0 3)、B细胞 (r=- 0 .2 2 1,P =0 .0 4 3)和CD8+ CD2 5 + 细胞 (r=- 0 .4 36 ,P =0 .0 0 0 )。结论　鼻咽癌初治患者的细胞免疫抑制与临床病期有关 ,还与HBV感染相关。CD4和CD8细胞百分比及其比值、CD8+ CD2 5Objective To determine the cellular immunity status by examining multiple parameters in untreated patients with nasopharyngeal carcinoma,and to evaluate the validity of each parameter.Methods Peripheral venous blood samples of 105 patients were analyzed with flow cytometry and 3H-TdR release test between March and December 2003 to determine the parameters including T lymphocyte subsets and activation level,B lymphocyte,NK,and LAK activity.The correlation of the parameters was analyzed in relation with the clinical stage of the tumor and HBV infection.Results According to 1992 staging scheme,the tumors were at stage Ⅰ in 6 patients,stage Ⅱ in 21 patients,stage Ⅲ in 48 patients,stage IVa in 30 patients.Blood BUN and Cr were roughly normal,with no HIV infection.CD8+ showed a significant correlation with tumor stage(r=0.218,P= 0.013) and the parameters that showed significant close correlations with tumor stage included CD4+/CD8+ ratio(P=0.051),CD8+CD25+(P=0.059),and LAK activity(P=0.057).Tumor stage showed relationship with HBsAg presence (r=0.220,P=0.012).After excluding the cases with HBV infection,the parameters that showed significant correlations with tumor stage included CD4+(r=-0.253,P=0.025),CD8+(r=0.284,P=0.013),CD4+/CD8+ ratio(r=-0.346,P=0.003),B lymphocyte(r=-0.221,P=0.043),and CD8+CD25+(r= -0.436,P=0.000).Conclusion The cellular immunity suppression in untreated patients with nasopharyngeal carcinoma is related with the clinical tumor stage,and can be influenced by HBV infection.Determining parameters of CD4+,CD8+,CD4+/CD8+ ratio,CD8+CD25+,and LAK activity,can be valid.

关 键 词：鼻咽肿瘤 细胞免疫 白细胞介素2受体 流式细胞术 

分 类 号：R739.63[医药卫生—肿瘤] R730.3[医药卫生—临床医学]