氩氦冷冻消融对晚期肾癌外周血调节性T细胞的影响  

Effect of Argon-Helium Cryosurgery on Regulatory T Lymphocytes in the Peripheral Blood of Patients with Advanced Renal Carcinoma

作　　者：刘长富[1] 郭志[1] 邢文阁[1] 刘方[1] 司同国[1] 于海鹏[1] 

机构地区：[1]天津市肿瘤防治重点实验室,天津医科大学附属肿瘤医院介入治疗科,天津市300060

出　　处：《中国肿瘤临床》2010年第6期317-319,共3页Chinese Journal of Clinical Oncology

基　　金：国家科技支撑计划课题资助(编号:2007BAI05806)

摘　　要：目的:研究氩氦冷冻消融治疗对晚期肾癌患者外周血CD4+CD25+调节性T细胞(Treg)的影响及临床意义。方法:回顾性分析本院32例晚期肾癌患者临床资料,所有患者均于氩氦冷冻消融治疗术前、术后1～6个月分别取外周血,应用流式细胞仪检测外周血T淋巴细胞亚群(CD3+T、CD4+T、CD8+T、CD4+T/CD8+T、NK细胞、Treg细胞)变化情况。术后1个月采用增强MR1或CT评价肿瘤坏死情况,影像学显示肿瘤无强化区即认为肿瘤坏死,根据Cavalieri方法计算肿瘤坏死率,进而评价肿瘤负荷。结果:冷冻消融治疗术后,Treg细胞比例由术前(4.18±1.58)%逐渐下降至第3个月达最低值(1.96±0.54)%,二者差异有统计学意义(P=0.001)。CD3+T、CD4+T、CD4+T/CD8+T、NK细胞比例分别由术前(19.26±7.52)%、(43.54±12.99)%、(1.15±0.57)%、(17.49±8.36)%逐渐上升至第3个月达最大值(30.83±5.69)%、(49.58±10.76)%、(1.84±0.12)%、(27.63±8。20)%,差异均有统计学意义(P=0.000,P=0.003,P=0.02,P=0.001)。CD8+T由术前(40.86±8.89)%逐渐下降至第3个月达最低值(26.74±4.29)%,差异具有统计学意义(P=0.000)。冷冻治疗后3～6个月CD3+T、CD4+T、CD4+T/CD8+T、NK、CD8+T、Treg细胞比例虽略有改变但差异均无统计学意义(P>0.05)。相关性分析结果表明:经氩氦冷冻治疗后Treg细胞比例变化与肿瘤负荷下降程度呈正相关(r=0.793,P<0.01)。结论:肾癌氩氦冷冻治疗后外周血T淋巴细胞亚群分布异常得到一定改善,抗肿瘤免疫反应增强,Treg细胞比例变化与肿瘤负荷有关。Objective： To analyze the effect of Argon-Helium cryosurgery （AHCS） on CD4＋ CD25＋ regulatory T cells （Treg） and its implication in patients with advanced renal carcinoma.Methods：,Peripheral venous blood samples were ob-tained from 32 patients with advanced renal cell carcinoma before and after AHCS.The proportions of Treg cells and T lym-phocyte subsets （CD3＋ T, CD4＋ T, CD8＋ T, CD4＋ T/CD8＋ T, and NK cells） in the peripheral blood were measured by flow cytometry.Enhanced CT or enhanced MRI was used to observe the necrosis of tumor at 1 month after AHCS.The areas with no imaging enhancement in tumor were regarded as tumor necrosis.The necrosis rate was measured by Cavalieri method and the tumor burden was evaluated.Results： At 3 months after AHCS, the percentages of Treg cells were gradual-ly decreased from 4.18%±1.58% to 1.96%±0.54%, with a significant difference （P=0.001）.At 3 months after AHCS, the pro-portions of CD3＋ T, CD4＋ T, NK and CD4＋ T/CD8＋ T were gradually increased from 19.26%±7.52%, 43.54%±12.99%, 1.15%±0.57%, and 17.49%±8.36% to 30.83%±5.69%, 49.58±10.76%, 1.84%±0.12%, and 27.63%±8.20%, with a statistical significance （P=0.000, P=0.003, P=0.02, and P=0.001）.The proportion of CD8 ＋ T was decreased from 40.86%±8.89% to the lowest ratio （26.74%±4.29%） at 3 months after AHCS, with a significant difference （P=0.000）.At 3～6 months after cryo-therapy, there was only a slight change in the proportions of CD3 ＋ T, CD4 ＋ T, CD4 ＋ T/CD8 ＋ T, NK, CD8 ＋ T, and Treg cells, with no significant difference （P〉0.05）.Correlation analysis showed that the decrease in tumor burden was positively correlated with the decrease of the proportion of Treg cells （r=0.793, P〈0.01）.Conclusion： After AHCS, the distribution of T-lymphocyte subsets can be improved and the anti-tumor immune response was strengthened.The percentage of Treg cells is correlated with tumor burden.

关 键 词：肾癌 氩氦冷冻 CD4+CD25+调节T细胞 T淋巴细胞 

分 类 号：R737.11[医药卫生—肿瘤]