胰十二指肠切除术对胰头癌患者CD4^+CD25^+调节性T细胞的影响及临床意义  

Influence of Pancreatoduodenectomy on CD4^+CD25^+ T Cells in Patients with Pancreatic Head Carcinoma and Its Clinical Significance

作　　者：林琳[1] 梁健[1] 马作红[2] 郭大伟[1] 王学范[1] 付庆才[2] 孙文郁[1] 姜洪磊[1] 金俊哲[1] 姜晓峰[1] 

机构地区：[1]中国医科大学附属第四医院肝胆胰外科,辽宁沈阳110032 [2]辽宁省肿瘤医院肝胆胰外科,辽宁沈阳110043

出　　处：《中国普外基础与临床杂志》2011年第1期51-54,共4页Chinese Journal of Bases and Clinics In General Surgery

基　　金：辽宁省教育厅高等学校科研计划项目(项目编号:2008824)~~

摘　　要：目的研究胰头癌患者外周血中CD4+CD25+调节性T细胞(Treg)比例及其在手术前、后的变化趋势。方法采用流式细胞仪检测胰头癌患者及正常对照组外周血中CD4+CD25+调节性T细胞的数量,同时监测CD4+/CD8+比值,并进行手术前、后的比较。结果胰头癌患者术前外周血中CD4+CD25+和CD4+CD25highTreg所占比例较正常对照组高(P<0.05),术后则出现不同程度下降,以术后第3天下降最明显(P<0.01,P<0.05);胰头癌患者术后CA19-9水平低于术前,以术后第14天下降明显(P<0.05)。CD4+CD25highTreg与CA19-9的变化趋势大致相同。胰头癌患者术前CD4+/CD8+比值比正常对照组低(P<0.05),手术后进一步降低,于手术后第7天达最低(P<0.05)。结论胰十二指肠切除术可能有助于机体抗肿瘤免疫的恢复,胰头癌患者围手术期可作为免疫干预的重要窗口期,CD4+CD25+调节性T细胞可作为免疫干预的靶点。Objective To investigate the proportion of peripheral blood CD4^＋CD25^＋ regulatory T cells（Tregs） in patients with pancreatic head carcinoma,the dynamic changes of these cells before and after pancreatoduodenectomy were also analyzed.Methods The proportions of peripheral blood CD4^＋CD25^＋ Tregs in patients with pancreatic head carcinoma and normal individuals were examined by using flow cytometric analysis.The CD4^＋/CD8^＋ ratio was also studied before and after operation.Results The patients with pancreatic head carcinoma showed higher ratio of CD4^＋CD25^＋ and CD4＋CD25high Tregs compared with normal control before operation（P〈0.05）.However,the percentage of these T cells reduced significantly after pancreatoduodenectomy,which was most obviously on the 3rd day after operation（P0.01,P〈0.05）.After operation,CA19-9 level began to decrease,which was obvious on the fourteen day after operation.This tendency of CD4＋CD25high Tregs changes was similar to that of CA19-9.The patients showed an decreased ratios of CD4^＋/CD8^＋ compared with normal controls,which further declined after operation,and reached the lowest point on the seventh day after operation（P〈0.05）.Conclusions Pancreatoduodenectomy may be helpful for the recovery of anti-tumor immunity.The perioperative period of patients with pancreatic head carcinoma may be a beneficial window-phase for immune intervention and Tregs may be served as target cells.

关 键 词：胰头癌 胰十二指肠切除术 调节性T细胞 免疫耐受 

分 类 号：R735.9[医药卫生—肿瘤]