乳腺癌患者围手术期NK细胞及其亚群的动态变化  

Dynamic changes of NK cells and their subsets in perioperative period of patient with breast cancer

作　　者：朱琪[1] 侯晓敏[1] 秦华晖[1] 葛丹红 金中淦 金姝[2] 朱晴晖[2] 

机构地区：[1]上海市普陀区人民医院外科,上海200060 [2]上海市普陀区人民医院医学科研实验中心,上海200060

出　　处：《中国肿瘤临床与康复》2010年第4期313-316,320,共5页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨乳腺癌患者围手术期NK细胞及其亚群的变化及其临床意义。方法以乳腺良性肿瘤患者8例、健康人14例为对照,乳腺癌患者29例手术前后,分别用流式细胞术测定外周血NK细胞及其亚群的变化。结果乳腺癌患者外周血淋巴细胞群中CD56+细胞和CD3-CD16+CD56+的百分率以及CD56+细胞群中CD3-CD16+CD56dim的百分率等3个指标均较健康对照和良性乳腺良性肿瘤组明显低下(P值均为0.000),CD56+细胞群中CD3-CD16+CD56bright细胞的百分率与两对照组比较差异无显著性。乳腺癌患者术后1 d上述3指标均较术前明显下降(P值均为0.000),术后7 d,外周血淋巴细胞群中CD56+细胞的百分率仍明显低于术前(P=0.024),另两指标与术前差异无显著性,术后1 d和7 d外周血CD56+细胞群中CD3-CD16+CD56bright细胞的百分率与术前的差异均无显著性。结论乳腺癌患者NK细胞及其亚群CD3-CD16+CD56dim明显低于健康对照和乳腺良性肿瘤患者,手术应激会导致其进一步下降,围手术期应密切观察NK细胞尤其是CD3-CD16+CD56dim亚群的变化,并给予适当的免疫干预。Objective To explore the changes of NK cells and their subsets in perioperative period of patient with breast cancer and their clinical significance.Methods Eight patients with benign breast tumor and 14 healthy donors were used as controls,changes of NK cells and their subsets in peripheral blood were detected by FACS in 29 patients with breast cancer before and after operation.Results Three indices [CD56＋/PBL（peripheral blood lymphocyte）,CD3-CD16＋CD56＋/PBL,CD3-CD16＋CD56dim/CD56＋] of patients with breast cancer were significantly lower than those of healthy and benign breast tumor controls（P=0.000）,while there was no difference in the ratio of CD3-CD16＋CD56bright/ CD56＋ between breast cancer patients and controls.In the group of breast cancer patient,the former 3 indices on the 1st day after operation were all decreased obviously compared with those before operation（P=0.000）,meanwhile,on the 7th day after operation,the percentage of CD56＋/PBL was still less than that before operation（P=0.024） while the other two indices displayed no statistic difference compared with those before operation.In addition,the percentage of CD3-CD16＋CD56bright/ CD56＋ on the 1st and 7th day after operation showed no difference with that before operation.Conclusion The NK cells and CD3-CD16＋CD56dim subsets in patient with breast cancer were significantly lower than those in healthy control and patients with benign breast tumor.Surgical stress could result in further decline of NK cells and their subsets.The change of NK cells especially CD3-CD16＋CD56dim subset in perioperative period should be observed closely and intervened by appropriate immunological method.

关 键 词：乳腺肿瘤 围手术期 CD56bright CD56dim NK细胞亚群 

分 类 号：R737.9[医药卫生—肿瘤] R730.45[医药卫生—临床医学]