肺腺癌患者外周血Treg和Th17细胞的变化及其对预后的影响  

Changes of Treg and Th17 cells in the peripheral bloods of patients with lung adenocarcinoma and their prognostic significance

作　　者：范恒建[1] 张玉可[1] 肖伟[1] 张一[1] 李海军[1] 王得翔[1] 

机构地区：[1]山东大学齐鲁医院呼吸科,济南250012

出　　处：《山东大学学报（医学版）》2012年第9期73-78,共6页Journal of Shandong University:Health Sciences

摘　　要：目的探讨肺腺癌患者外周血Treg细胞和Th17细胞比例变化及其临床意义。方法选择2011年5月至11月住院治疗的肺腺癌患者39例为肺腺癌组,健康志愿者20例为对照组。采用流式细胞术测定外周血Treg和Th17细胞的比例,酶联免疫吸附法(ELISA)测定外周血IL-17水平;比较肺腺癌Ⅰ+Ⅱ期、Ⅲ+Ⅳ期以及其中14例接受手术的患者在肿瘤切除前后上述各指标的变化;用复发转移和FACT-L生活质量评分等指标对手术患者进行术后随访。结果①肺腺癌组外周血Treg、Th17细胞及IL-17水平较对照组升高;②肺腺癌淋巴结转移和远处转移与Treg细胞呈正相关,与Th17细胞呈负相关;③肺腺癌术后Th17及IL-17水平较术前降低;④肺腺癌术后FACT-L生活质量评分与术前Treg细胞呈负相关,与Th17细胞呈正相关;术前Treg细胞大于Treg细胞均值和Th17细胞小于Th17细胞均值的患者,术后复发转移率高。结论肺腺癌患者外周血中Treg和Th17细胞比例的异常变化与肿瘤负荷相关,Treg细胞比例增高是肺腺癌预后的负性指标,可能与CD8+T细胞受抑制关系密切,而Th17细胞比例增高对肿瘤预后可能具有积极的意义。Objective To investigate the frequencies of Treg and Th17 in patients with lung adenocarcinoma and explore their clinical significance.Methods Frequencies of Treg and Th17 cells were detected in 39 patients with lung adenocarcinoma who were hospitalized from May to November in 2011（lung adenocarcinoma group） and 20 healthy volunteers（control group） by flow cytometry.Enzyme-linked immunosorbent assay（ELISA） was used to detect serum concentration of IL-17.The above indexes were compared among patients in gradeⅠ＋Ⅱ,grade Ⅲ＋Ⅳ and 14 patients who underwent operations.Follow-up visits were performed for the postoperative patients.The follow-up indexes include local recurrence,lymph node metastasis,distant metastasis and functional assessment of cancer therapy-lung（FACT-L）.The relationships between these indexes and the levels of Treg and Th17 were then analyzed.Results ① Levels of Treg,Th17 cells and IL-17 in lung adenocarcinoma group were significantly higher than those in control group.② Frequency of Treg had positive correlation with the situation of lymph node metastasis and distant metastasis,while levels of Th17 and IL-17 had negative correlation with it.③ Frequency of Th17 in the postoperative patients was significantly lower than that in the preoperative patients,accompanied by1decreased serum concentration of IL-17.④ FACT-L in postoperative patients had negative correlation with the level of Treg before operation,while it had positive correlation with the level of Th17 before operation.Postoperative patients had higher relapse and metastasis rate when preoperative Tregmean of Treg and Th17mean of Th17.Conclusion There are abnormal changes of Treg and Th17 which are related to the tumor load in the peripheral blood of patients with lung adenocarcinoma.High proportion of Treg is the negative prognostic factor of lung adenocarcinoma,which may be closely related to the inhibition of CD8＋T cells.High proportion of Th17 probably has a positive impact on the favorable prognosis of

关 键 词：TREG细胞 TH17细胞 肺腺癌 肿瘤免疫 流式细胞术 酶联免疫吸附法 

分 类 号：R734.2[医药卫生—肿瘤]