大肠癌患者化疗前后淋巴细胞亚群变化  

Changes of Lymphocyte Subsets before and after Chemotherapy in Colorectal Carcinoma Patients

作　　者：张国庆[1] 赵宏[1] 温新宇[2] 李瑾昱[1] 吴亮亮[3] 焦顺昌[1] 

机构地区：[1]中国人民解放军总医院肿瘤内科,北京100853 [2]中国人民解放军总医院生化科,北京100853 [3]中国人民解放军总医院肿瘤中心实验室,北京100853

出　　处：《中国医学科学院学报》2013年第2期155-160,共6页Acta Academiae Medicinae Sinicae

基　　金：国家科技部支撑计划基金(2009BAI86B05)~~

摘　　要：目的分析62例大肠癌患者化疗前后21项淋巴细胞亚群变化情况。方法用三标荧光抗体对62例大肠癌患者接受FOLFOX4(奥沙利铂+5-氟尿嘧啶+亚叶酸钙)、FOLFRI(伊立替康+5-氟尿嘧啶+亚叶酸钙)或XELOX(奥沙利铂+卡培他滨)方案化疗前后外周血21项淋巴细胞亚型进行标记,流式细胞仪检测,分析化疗前后淋巴细胞亚群的变化,并根据化疗方案及化疗周期数的不同进行亚组分析。结果大肠癌患者化疗后CD3+、CD3+CD8+、CD29+、CD4+CD29+、CD4+CD25+细胞在外周血淋巴细胞中的百分比较化疗前明显升高,CD19+、人白细胞(位点)DR抗原(HLA-DR)+细胞百分比明显降低(P<0.05)。亚组分析结果显示:FOLFOX4方案化疗组CD3+CD8+、CD4+CD25+细胞化疗后较化疗前明显升高,CD19+和HLA-DR+细胞明显降低(P<0.05);XELOX方案化疗组CD3+CD8+细胞明显升高,CD19+细胞明显降低(P<0.05),而接受FOLFRI方案化疗组所有细胞亚群化疗前后差异均无统计学意义(P>0.05);化疗≤4周期组患者CD3+、CD3+CD8+、记忆性T细胞(CD45RO+)、CD4+CD45RO+细胞化疗后较化疗前明显升高(P<0.05),化疗5～8周期组患者HLA-DR+细胞明显降低(P<0.05),化疗≥9周期组CD29+细胞明显升高(P<0.05)。结论化疗使大肠癌患者体液免疫功能下降;FOLFOX4化疗方案可能抑制机体细胞免疫功能;≤4周期的化疗可通过对机体免疫格局的调整增强机体细胞免疫功能,但随着化疗次数的增加,机体细胞免疫功能逐渐下降。Objective To investigate the change of lymphocyte subsets before and after chemotherapy in colorectal carcinoma patients. Methods Twenty-one peripheral blood lymphocyte subsets from 62 colorectal carcinoma patients before and after FOLFOX4 （including oxaliplatin, 5-fluorouracil and leucovorin）, FOLFRI （including irinotecan, 5-fluorouracil and leucovorin）, or XELOX （including oxaliplatin and capecitabine ） regimen chemotherapy were examined by flow cytometry. The differences of these lymphocyte subsets were ana-lyzed. Results After chemotherapy, the percentages of CD3＋ , CD3＋ CD8＋ , CD29＋ , CD4＋ CD29 ＋ , and CD4＋ CD25 ＋ cells in peripheral blood of colorectal carcinoma patients increased significantly, while the percent- ages of CD19＋ and human leukocyte antigen （locus） DR （HLA-DR） ＋ cells decreased significantly （P 〈 0. 05 ）. The results of subgroup analysis showed that the patients＇ CD3＋ CD8 ＋ and CD4 ＋ CD25＋ cells increased significantly, CD19 ＋ and HLA-DR ＋ cells decreased significantly after FOLFOX4 regimen chemotherapy （P 〈 0. 05） ; CD3＋ CD8＋ cells increased significantly and CD19＋ cells decreased significantly after XELOX regimen chemotherapy （ P 〈 0.05 ） ; while after FOLFRI regimen chemotherapy, there were no significant changes in all 21 lymphocyte subsets （P 〉0.05）. CD3＋, CD3＋ CD8＋, memory T lymphoctye （45RO＋ ）, and CI4＋ CD45RO ＋ cells increased significantly （ P 〈 0. 05 ） in patients who received no more than 4 cycles of chemother- apy. However, in patients that received 5 to 8 cycles and more than 9 cycles chemotherapy, we only found sig- nificant decrease of HLADR ＋ cells and significant increase of CD29 ＋ cells, respectively （P 〈 0. 05）. Conclu- sions The humoral immunity is attenuated after chemotherapy in colorectal carcinoma patients. FOLFOX4 may suppress the cellular immunity. Chemotherapy that is less than 4 cycles will strengthens the cellular immunity by modulating body immunity

关 键 词：大肠癌 化疗 免疫功能 淋巴细胞亚群 

分 类 号：R735.3[医药卫生—肿瘤]