青年结直肠癌患者外周血CD4^+CD29^+T细胞水平及其临床意义  

Level of peripheral blood CD4^+CD29^+ T cells and its clinical significance for young patients with colorectal carcinoma

作　　者：敖永曦 张启洪 伍时佐 郑俏聪 李丹 吴盛 许云朋 谢小娥 

机构地区：[1]阳江市人民医院肿瘤一科,广东阳江529500

出　　处：《中国临床研究》2016年第7期909-912,共4页Chinese Journal of Clinical Research

摘　　要：目的探讨青年结直肠癌(CRC)患者外周血CD4+CD29+T细胞含量的变化及其临床意义。方法收集43例青年CRC(青年CRC组)及132例中老年CRC(中老年CRC组)患者作为观察对象,以65例慢性结肠炎患者(慢性结肠炎组)及73例健康人(健康组)作为对照。采用双激光光源多色流式细胞仪检测外周血CD4+CD29+T细胞及其胞内细胞因子肿瘤坏死因子α(TNF-α)及γ干扰素(IFN-γ)的相对百分含量;采用酶联免疫吸附(ELISA)法检测外周血肿瘤标记物癌胚抗原(CEA)、糖链抗原19-9(CA19-9)、血管内皮生长因子(VEGF)及转化生长因子β1(TGF-β1)含量,观察不同分期青年CRC患者肿瘤标记物的差异,并分析CD4+CD29+T细胞及其胞内细胞因子与肿瘤标记物的相关性。结果青年及中老年CRC患者CD4+CD29+T细胞及胞内TNF-α相对百分含量均显著高于慢性结肠炎组及健康组,且青年CRC组显著高于中老年组(P均<0.05)。青年及中老年CRC患者胞内IFN-γ相对百分含量均显著低于慢性结肠炎组及健康组,且青年组显著低于中老年组(P均<0.05)。Ⅰ期CEA及CA19-9含量显著低于Ⅲ及Ⅳ期,且Ⅳ期显著高于Ⅲ期,但Ⅰ期与Ⅱ期无显著差异(P均>0.05);VEGF及TGF-β1含量均表现为明显的梯度:Ⅳ>Ⅲ>Ⅱ>Ⅰ期,且任意两组间的含量差异均有统计学意义(P均<0.05)。CD4+CD29+T细胞及TNF-α水平均与四项肿瘤标记物呈显著正相关,但IFN-γ水平与四项肿瘤标记物呈显著负相关(P<0.05,P<0.01)。结论 CD4+CD29+T细胞及胞内TNF-α升高、IFN-γ降低,对CRC发病机制及患病年龄均具有一定的特异性,且三者与肿瘤标记物呈显著相关性,在鉴别中早期青年CRC具有重要的临床意义。Objective To investigate the change of CD4＋CD29＋T cells content of peripheral blood in young patients with colorectal carcinoma（ CRC） and its clinical significance. Methods Forty-three young CRC patients（ young CRC group）and 132 middle- and old-aged CRC patients（ middle- and old-aged CRC group） were collected as research objects,and 65 chronic colitis patients（ chronic colitis group） and 73 healthy subjects（ health group） were served as control. Double laser light source multi-color flow cytometry was used to detect the relative percentage composition of peripheral blood CD4＋CD29＋T cells and their intracellular cytokines including tumor necrosis factor α（ TNF-α） and interferon-γ（ IFN-γ）. Enzyme linked immunosorbent assay（ ELISA） method was used to detected the contents of peripheral blood tumor markers including carcinoembryonic antigen（ CEA）,carbohydrate antigen 19-9（ CA19-9）,vascular endothelial growth factor（ VEGF） and transforming growth factorβ1（ TGF-β1）. The differences of tumor markers in young CRC patients with different stages were observed. The correlations of CD4＋CD29＋T cells and their intracellular cytokines with tumor markers was analyzed. Results The relative percentages composition of peripheral blood CD4＋CD29＋T cells and intracellular TNF-αin young CRC group and middle- and old-aged CRC group were all significantly higher than those in chronic colitis group and health group which in young CRC group were significantly higher than those in middle- and old-aged CRC group（ all P〈0. 05）,while the relative percentages composition of intracellular IFN-γ in young CRC group and middle- and old-aged CRC group were all significantly lower than those in chronic colitis group and health group which in young CRC group were significantly lower than those in middle- and old-aged CRC group（ all P〈0. 05）. The contents of VEGF 及 TGF-β1showed a marked gradient（ stages Ⅳ Ⅲ Ⅱ Ⅰ）,and there were significant differences in c

关 键 词：结直肠癌 CD4+CD29+T细胞 肿瘤坏死因子α γ干扰素 癌胚抗原 糖链抗原19-9 转化生长因子β1 血管内皮生长因子 青年患者 

分 类 号：R735.3[医药卫生—肿瘤]