结直肠癌及腺瘤患者CD4^+、CD8^+和CD28^+T淋巴细胞的亚群变化及临床意义  

Subsets and clinical significance of CD4^+, CD8^+ and CD28^+ T lymphocytes in the patients with colorectal carcinoma and adenoma

作　　者：张泉[1] 邱思芳 赵逵[1] 朱蓉[1] 汪煜鹏 张海[1] 牟兰兰 ZHANG Quan;QIU Sifang;ZHAO Kui;ZHU Rong;WANG Yupeng;ZHANG Hai;MOU Lanlan(Department of Gastroenterology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,Guizhou Province,China)

机构地区：[1]遵义医学院附属医院消化内科,贵州遵义563000

出　　处：《中国癌症杂志》2018年第8期577-583,共7页China Oncology

基　　金：国家自然科学基金资助项目(81560467);贵州省高层次人才科研条件特助基金资助项目(TZIF2011-32);贵州省科学技术基金资助项目(LKZ2013-18);遵义医学院博士科研启动基金(F-572)

摘　　要：背景与目的:结直肠癌(colorectal cancer,CRC)严重影响患者生存。探讨肿瘤微环境(tumor microenvironment,TME)T细胞亚群在CRC和腺瘤中的表达及意义。方法:用免疫组织化学法和流式细胞术对51例健康人(对照组)、46例结直肠腺瘤(腺瘤组)、100例CRC(癌症组)和15例CRC术后(癌术后组)患者进行T细胞亚群检测。结果:(1)对照组、腺瘤组及癌症组3组中CD4^+T细胞的阳性率分别是90.00%、43.75%及32.65%,CD8^+T淋巴细胞的阳性率分别是30.00%、56.25%及75.51%,CD28^+T淋巴细胞的阳性率分别是42.86%、30.00%及20.00%。(2)对照组、腺瘤组及癌症组3组中CD4^+、CD4^+/CD8^+、CD28^+、CD8^+CD28^+和CD8^-CD28^+逐渐降低,CD8^+、CD8^+CD28-逐渐增加(P<0.05);癌术前术后T细胞亚群差异有统计学意义(P<0.05)。结论:(1)CRC微环境T细胞亚群中CD4^+、CD4^+/CD8^+、CD28^+、CD8^+CD28^+和CD8^-CD28^+呈递减趋势,CD8^+、CD8^+CD28^-呈递增趋势,且在癌前病变腺瘤中已逐步出现上述趋势变化。(2)CRC患者行肿瘤切除术后,其T细胞亚群有所恢复,故在一定程度上,CRC中T细胞亚群的变化可以早期预测结直肠疾病的发展。Background and purpose:Colorectal cancer(CRC)is a disease that seriously affects the quality of life.This study aimed to investigate the subsets and significance of tumor cell microenvironment T cell in CRC and adenoma.Methods:Immunohistochemistry and flow cytometry were used to test T lymphocyte subsets in 51 healthy subjects(control group),46 patients with colorectal adenomas(adenoma group),100 CRC patients(cancer group),and 15 postoperative patients with CRC(postoperative group).Results:The positive rates of CD4+T cells in the control group,adenoma group and cancer group were 90.00%,43.75%and 32.65%,respectively.The positive rates of CD8+T lymphocytes were 30.00%,56.25%and 75.51%,respectively.The positive rates of CD28+T lymphocytes were 42.86%,30.00%and 20.00%,respectively.The levels of CD4^+,CD4^+/CD8^+,CD28^+,CD8^+CD28^+and CD8^-CD28^+in the control group,adenoma group and cancer group gradually decreased,while the CD8^+and CD8^+CD28^-levels gradually increased(P<0.05).The difference in T cell subsets between preoperative and postoperative patients was statistically significant(P<0.05).Conclusion:CD4^+,CD4^+/CD8^+,CD28^+,CD8^+CD28^+and CD8^-CD28^+in the subgroup of colorectal tumor microenvironment showed a declining trend,while CD8+and CD8+CD28-showed an increasing trend.Moreover,these trends gradually appeared in precancerous adenomas.After CRC patients underwent tumor resection,their T cell subsets recovered.Therefore,to some extent,the changes of T cell subsets in CRC can predict the development of colorectal disease early.

关 键 词：肿瘤微环境 结直肠癌 结直肠腺瘤 T淋巴细胞亚群 流式细胞术 

分 类 号：R735.3[医药卫生—肿瘤]