老年原发性非小细胞肺癌患者外周血中CD28/CTLA-4 mRNA含量变化及临床意义  

The contents and clinical significance of CD28 and CTLA-4 mRNA in peripheral blood of elderly patients with primary non-small cell lung cancer

作　　者：潘旭东[1] 王翎[1] 史进方[1] 蔡惠芬[1] 蒋敏[1] 张光波[1] 张学光[1] 

机构地区：[1]苏州大学附属第一医院江苏省临床免疫学实验室,江苏苏州215006

出　　处：《中国老年学杂志》2009年第12期1509-1512,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(30330540);江苏省卫生厅重点学科基金资助(No.200319)

摘　　要：目的探讨外周血中CD28/CTLA-4 mRNA含量的增龄性改变与老年原发性非小细胞肺癌(NSCLC)发生发展之间的联系。方法应用实时荧光定量PCR技术对63例老年NSCLC患者外周血单个核细胞CD28/CTLA-4 mRNA的含量进行检测,结果分别与老年健康组、老年肺良性病变组(老年非癌组)、年轻健康组、年轻肺良性病变组(年轻非癌组)以及年轻肺癌组进行对比分析,同时分析它们与临床病理特征之间的关系。结果老年肺癌组外周血中CD28 mRNA含量显著低于其余各组(P<0.01),而CTLA-4 mRNA含量则显著高于其余各组(P<0.01),老年健康组外周血中CD28 mRNA含量明显低于年轻健康组和年轻非癌组,而CTLA-4 mRNA含量则明显高于年轻健康组和年轻非癌组;老年非癌组与老年健康组比较,两者含量差异均无统计学意义。Logistic回归分析显示,年龄、CD28 mRNA含量、CTLA-4 mRNA含量均与肺癌的发生有统计学关联(均P<0.01),且CD28与CTLA-4的mRNA含量具有负相关性(r=-0.400,P<0.01)。另外,CD28及CTLA-4 mRNA的含量均与老年肺癌的临床TNM分期、细胞分化程度以及淋巴结转移状态密切相关(P<0.05,P<0.01),而与病理类型无关(P>0.05)。结论呈增龄性调节的CD28/CTLA-4 mRNA可能在老年人NSCLC的形成和演变过程中发挥着重要的调控作用。Objective To investigate the relationship between age-related changes of CD28 and CTLA-4 mRNA levels in peripheral blood and the oneogenesis and progression of primary non-small cell lung cancer （NSCLC） in elderly. Methods The levels of CD28 mRNA and CTLA-4 mRNA on peripheral blood mononuelear cell （ PBMC ） of 63 elderly patients with NSCLC aged ~〉 60 years were measured by fluorescent quantitation real-time PCR （FQ-PCR）. 35 elderly patients with lung benign lesion, 30 elderly healthy donors, 30 young healthy donors, 20 young patients with lung benign lesion and 20 young patients with NSCLC were enrolled as controls. Meanwhile, the relationship between CD28/CTLA-4 mRNA levels and clinical characteristics of NSCLC in elderly was analyzed with statistics. Results The level of CD28 mRNA was decreased （ P 〈 0. 01 ） and the level of CTLA-4 mRNA was increased （ P 〈 0.01 ） on PBMC of all elderly patients with NSCLC than those of the other groups. The level of CD28 mRNA of elderly healthy donors was significantly lower than that of young healthy donors and young patients with lung benign lesion, but the content of CTLA-4 mRNA of young healthy donors were significantly higher than that of young healthy donors and young patients with lung benign lesion. There were no significant difference in mRNA levels of CD28 and CTLA-4 between elderly healthy donors and elderly patients with lung benign lesion. Logistic regression analysis showed that the increased risk factors for lung cancer were significantly associated with aging, down-regulation of CD28 mRNA and up-regulation of CTLA-4 mRNA （OR = 2. 353）, and the level of CD28 mRNA had significant negative correlation with the level of CTLA-4 mRNA （ r = - 0. 400, P 〈 0.01 ）. In the elderly patients with NSCLC, the mRNA levels of CD28 and CTLA-4 in peripheral blood was closely associated with TNM stages, grade of cell differentiation and lymph node metastasis status （ P 〈 0.05 ）, but not related to pathological types （ P 〉 0. 05 ）. Co

关 键 词：老年人 非小细胞肺癌 CD28/CTLA-4 荧光实时定量PCR 

分 类 号：R734.2[医药卫生—肿瘤]