晚期肺腺癌患者外周血T细胞淋巴亚群的检测及危险因素评估  

Detection of T Lymphocyte Subsets in the Peripheral Blood of Patients with Advanced Lung Adenocarcinoma

作　　者：燕翔[1] 赵晓[1] 焦顺昌[1] 胡毅[1] 孙胜杰[1] 吴亮亮[1] 吴志勇[1] 

机构地区：[1]中国人民解放军总医院肿瘤内科,北京100853

出　　处：《中国医学科学院学报》2012年第3期234-238,共5页Acta Academiae Medicinae Sinicae

基　　金：军队十一五医药科研课题项目基金(06G106)~~

摘　　要：目的探讨晚期肺腺癌患者CD4+CD25+Treg细胞和其他T细胞亚群的变化及其临床意义。方法采用流式细胞术分析64例晚期肺腺癌患者外周血CD4+CD25+Treg细胞及其他T细胞亚群水平,并与33例健康对照者比较。结果晚期肺腺癌患者CD3+和CD3+CD4+比例分别为(66.5±11.0)%和(37.7±10.6)%,明显低于健康对照组的(72.0±6.0)%(t=-3.2,P=0.020)和(42.0±6.4)%(t=-2.4,P=0.015);CD4+CD25+的比例为(10.5±4.0)%,明显高于健康对照组的(8.4±3.5)%(t=-2.2,P=0.013);CD4+/CD8+为1.4±0.8,明显低于健康对照组的1.8±0.7(t=-2.2,P=0.029)。两组间CD3+CD8+、CD8+CD28-及CD8+CD28+的比例差异无统计学意义(P均>0.05)。肺癌患者T细胞亚群功能的损害与吸烟与否、肿瘤分化程度及肿瘤病灶大小无明显联系,与外周血癌胚抗原之间存在着一定的联系。结论晚期肺腺癌患者存在明显的细胞免疫功能障碍,Treg细胞在肺癌患者中比率明显升高,CD4+/CD8+明显降低,提示肺癌患者处于免疫抑制状态。吸烟与否、分化程度及肿瘤病灶大小与免疫功能紊乱的联系尚需进一步探讨。Objective To evaluate the CD4 ＋ CD25 ＋ regulatory T cells （Treg） and other lympho- cyte subsets in the peripheral blood of patients with advanced lung adenoearcinoma. Methods Peripheral blood samples were obtained from 64 patients with advanced lung adenocareinoma （ case group） and analyzed by flow cytometry. The ratios of CD4 ＋ CD25 ＋ Treg T cells and other T lymphocyte subsets in peripheral blood were compared with those from 33 healthy controls （ control group）. Results The percentages of CD3 ＋ and CD3 ＋ CD4 ＋ were （66.5±11.0）% and （37.7±10.6）% respectively in the peripheral blood of the case group, which were significantly lower than those [ （72.0±6.0） % and （42.0±6.4） % ] in the control group （ t = - 3.2, - 2.4 ; P = 0. 020, 0. 015, respectively）. The ratio of CD4 ＋ CD25 ＋ Treg cells in case group （10.5 ＋4.0）% was significantly higher than that [ （8.4±3.5）% ] in the control group （t = -2.2, P =0.013）. CD4 ＋/CD8 ＋ value of case group （ 1.4±0. 8 ） was significantly lower than that （ 1.8 _＋ 0.7） in control group （t = - 2.2, P = 0. 029）. CD3 ＋ CD8 ＋ , CD8 ＋ CD28-, and CD8 ＋ CD28 ＋ showed no signifi- cant differences （ all P 〉 0.05 ） . Smoking, differentiation grade, and size of the tumor showed no association with the function damage of T lymphocyte subsets, while the carcino-embryonic antigen level did. Conclusions In patients with advanced lung adenocarcinoma, Treg increases and CD4 ＋/CD8 ＋ decreases, suggesting re- markably suppressed immune functions. However, more research is warranted to validate the association of T cells subset dysfunction with smoking, differentiation grade, and size of tumor.

关 键 词：晚期肺腺癌 CD4+CD25+调节性T细胞 T细胞亚群 流式细胞术 

分 类 号：R730.3[医药卫生—肿瘤] R73-31[医药卫生—临床医学]