射波刀治疗对复发胶质瘤患者外周血CD4^+CD25^+Neuropilin-1^+调节性T细胞与近期疗效的影响  

The Influence on CD4^+CD25^+Neuropilin-1^+Treg of Peripheral Blood and the Short-term Curative Effect in Recurrent Glioma Patients Treated with Cyberknife Treatment

作　　者：范学政[1] 毛庆[2] 黄进能[1] 朱寿鸿[1] 胡栓贵[1] 李亚平[1] 洪翰明[1] 王伯强[1] 张雅轩[1] 姜盛强[1] 

机构地区：[1]广西中医药大学附属瑞康医院,广西南宁530011 [2]四川大学华西医院,四川成都610041

出　　处：《中国神经肿瘤杂志》2013年第2期113-117,共5页Chinese Journal of Neuro-Oncology

摘　　要：背景与目的:观察复发胶质瘤患者接受射波刀治疗后外周血CD4+CD25+Neuropilin-1+调节性T细胞(Treg)的变化,分析患者的近期疗效,旨在探讨射波刀对复发胶质瘤可能的治疗机制。方法:以12名健康成年人作为对照组,用流式细胞仪检测53例手术后复发的胶质瘤患者(分为A、B两组,A组为射波刀治疗组,n=25;B组为非射波刀治疗组,仅给予保守对症治疗而未进行任何放化疗,n=28)外周血CD4+CD25+Neuropilin-1+Treg水平,并进行30月的生存随访,观察两组的近期疗效。结果:治疗前A、B两组患者外周血CD4+CD25+Neuropilin-1+Treg分别为(13.44±2.76)%和(12.91±2.87)%,明显高于对照组(2.78±1.07)%(P<0.01)。A组经射波刀治疗3月后外周血CD4+CD25+Neuropilin-1+Treg水平为(3.13±1.09)%,较治疗前明显下降(P<0.01)。B组CD4+CD25+Neuropilin-1+Treg为(16.12±2.98)%,较3月前升高,但差异无统计学意义(P>0.05)。A组缓解率为76.0%,无进展率为12.0%,进展率为12.0%;B组缓解率为10.7%,无进展率为17.9%,进展率为71.4%。A组死亡5例(20%),中位生存时间13个月(3~31月)。B组随访死亡15例(53.6%),中位生存时间7个月(1~13月)。其中两组缓解率、进展率、死亡率及中位生存时间差异有统计学意义(P<0.05)。结论:复发胶质瘤患者体内CD4+CD25+Neuropilin-1+Treg升高,外周血CD4+CD25+Neuropilin-1+Treg检测有助于监测胶质瘤复发和预后的评估;射波刀可以降低复发胶质瘤患者的CD4+CD25+Neuropilin-1+Treg水平,近期疗效优于保守治疗;射波刀治疗复发胶质瘤的机理可能与解除瘤负荷、降低CD4+CD25+Neuropilin-1+Treg、纠正机体免疫功能紊乱有关。BACKGROUND ＆ OBJECTIVE： The percentage of CD4^＋CD25^＋Neuropilin-1^＋Treg cells is associated with the prognosis of glioma patient. This study was aimed to investigate the influence of cyberknife on the percentage of Treg cells peripheral blood in recurrent glioma patients and the short-term curative effect. METHODS： The Treg cells of peripheral blood was detected by the flow cytometer in53 patients （ Group A treated by eyberknife, n= 25; Group B treated by conservative treatment, n=28） with recurrent glioma and 12 healthy people as control group. All the patients were followed up for 30 months. RESULTS： The percentage of Treg cells of peripheral blood in patients of the group A and the groupB was （13.44＋2.76）% and （12.91＋ 2.87）%, respectively, which was significantly higher than that of control group （P〈0.01） .The percentage of Treg cells was （3.13±1.09）% in group A and decreased significantly compared to those before treatment after treatment of 3 months （P〈0.01）. The percentage of Treg cells in group B was （16.12±2.98）%, and there was no statistically significant increases （P〉0.05）. The remission rate, the progression-free rate, the progressive rate in group A was respectively 72.0%, 8.0%, 8.0% respectively. Those of the group B was 7.1%, 14.3%, 60.7%, respectively. Five （20%） patients died and the median survival time was 13 months in group A. Fifteen （53.6%） patients died and the median survival time was 7 months in group B. The remission rate, the progressive rate, the mortality rate and the median survival time had significant difference between two groups （P〈0.05）. CONCLUSIONS： The recurrent glioma was associated with a higher peripheral Treg cells （P〈0.01） and detection of the level of Treg cells was helpful to supervise the recurrence and assess the prognosis. Cyberknife could decrease the Treg cells of peripheral blood obviously and short-term curative effect were better in group A than group B. The treatment mechanism of cyb

关 键 词：胶质瘤 复发 CD4+CD25+Neuropilin-1+调节性T细胞 近期疗效 

分 类 号：R739.41[医药卫生—肿瘤]