紫杉醇联合顺铂化疗对口腔癌患者外周血细胞免疫的影响  

Effect of paclitaxel combined with cisplatin chemotherapy on peripheral blood cell immunity in patients with oral carcinoma

作　　者：李向春[1] 邸瑞玲[1] 张鑫 张素欣[2] LI Xiangchun;DI Ruiling;ZHANG Xin;ZHANG Suxin(Department of Stomatology First Hospital of Qiahuangdao City, Qinhuangdao 06600)

机构地区：[1]秦皇岛市第一医院口腔科,066000 [2]河北医科大学第四医院口腔科

出　　处：《现代口腔医学杂志》2018年第3期138-141,共4页Journal of Modern Stomatology

基　　金：河北省卫计委2016年度医学科学研究重点课题计划项目(20160190)

摘　　要：目的通过检测化疗前后外周血T细胞表型及其细胞因子的变化,分析紫杉醇联合顺铂化疗对口腔癌患者细胞免疫的影响。方法随机选取30例临床分期为Ⅲ期和Ⅳ期的口腔癌患者为实验对象,应用紫杉醇联合顺铂化疗,分别于化疗前后采集患者外周血2ml,通过流式细胞术检测外周血中T细胞表型的变化,并通过ELISA法检测细胞因子的变化,以30名健康志愿者外周血为对照。结果使用SPSS 22.0软件进行统计学分析,以P<0.05为有统计学意义。结果口腔癌患者外周血中CD3^+、CD4^+T淋巴细胞较正常人群比率降低,CD8^+T淋巴细胞比率增加,CD4/CD8比值下降或倒置,差别均有统计学意义(P<0.05)。同化疗前相比,口腔癌患者化疗后CD4+T淋巴细胞的表达增加,CD8^+细胞毒性T细胞的比例下降,CD4/CD8比值倒置情况得以逆转。Th1细胞较化疗前明显提高,Th2细胞无明显变化。但CD56^+T细胞较化疗前出现不同程度的下降,其差异无显著性。细胞因子INF-γ、IL-2显著上升(P<0.05),IL-4无明显变化。结论口腔癌患者细胞免疫处于抑制状态,紫杉醇联合顺铂化疗通过上调CD4^+T细胞改善口腔癌患者免疫功能,增强口腔癌的治疗效果。Objective The effects of paclitaxel combined with cisplatin on cellular immunity in patients with oral carcinoma were analyzed by detecting the changes of T cell phenotype and cytokines in peripheral blood before and after chemotherapy.Methods A total of 30 patients with oral carcinoma at stage Ⅲ and Ⅳ were randomly selected.Paclitaxel combined with cisplatin chemotherapy was used,then 2ml of peripheral blood of patients was collected before and after chemotherapy.Flow cytometry was used to detect the changes of T cell phenotype and cytokines in peripheral blood.30healthy volunteers severed as the control.The results were statistically analyzed by SPSS 22.0 software,with P〈0.05 was statistically significant.Results The CD3^＋,CD4^＋T lymphocytes expression of patients with oral carcinoma is lower compared with normal populations.CD4/CD8 is decreased or reverse,the difference is significant（P〈0.05）.When the patients undergone a period of chemotherapy,the CD4^＋T lymphocytes expression increased,whereas the CD8^＋T lymphocytes decreased.And the CD4/CD8 ratio reversed.Th1 cells were significantly increased before chemotherapy,and there was no significant change in Th2 cells.However,CD56^＋T cells decreased to varying degrees after chemotherapy,although there was no significant difference between them.The cytokines INF-γand IL-2 increased significantly（P〈0.05）,and there was no significant change in IL-4.Conclusion The cellular immunity in patients with oral carcinoma is in an inhibitory state.Paclitaxel combined cisplatin chemotherapy improves the immune function of oral cancer patients by upregulating CD4＋T cells and enhances the therapeutic effects of oral cancer.

关 键 词：口腔癌 化疗 T淋巴细胞 INF-Γ IL-2 

分 类 号：R739.8[医药卫生—肿瘤]