胃癌患者外周血淋巴细胞亚群检测的临床意义  

The clinical significance of detection of peripheral blood lymphocyte subsets in patients with gastric cancer

作　　者：华忆雯 于欣宇 袁吉祥 陈昱延 刘家洲 胡懿淋 薛万江[2] HUA Yiwen;YU Xinyu;YUAN Jixiang;CHEN Yuyan;LIU Jiazhou;HU Yilin;XUE Wanjiang(Medical College of Nantong University,Nantong 226001;Department of Gastrointestinal Surgery,the Affiliated Hospital of Nantong University)

机构地区：[1]南通大学医学院,南通226001 [2]南通大学附属医院胃肠外科

出　　处：《南通大学学报（医学版）》2020年第2期156-159,共4页Journal of Nantong University(Medical sciences)

基　　金：南通大学大学生创新创业训练计划项目(2018143),江苏省研究生科研与实践创新计划项目(SJCX18_0831)。

摘　　要：目的:了解胃癌患者外周血淋巴细胞亚群比例的变化和临床意义。方法:收集健康正常受试者20例、胃溃疡患者20例、胃癌患者100例术前的外周血样本,应用流式细胞术检测外周血中CD3^+T细胞、CD4^+T细胞、CD8^+T细胞、Tregs细胞、自然杀伤(natural killer,NK)细胞和CD19^+B细胞所占比例,结合临床资料进行分析,并利用受试者工作特征曲线(receiver operating characteristic curve,ROC曲线)分析NK细胞比例的临床诊断临界值。结果:胃癌患者术前外周血中NK细胞比例较胃溃疡患者和健康人群显著升高(P<0.05),而其他外周血淋巴细胞亚群的变化差异无统计学意义(P>0.05)。外周血NK细胞的比例还与胃癌的T分期、N分期、TNM分期和分化水平相关(P<0.05)。ROC曲线分析显示外周血NK细胞比例在胃癌中的诊断临界值为11.61%,该临床诊断临界值灵敏度为88.0%,特异性为80.0%。结论:外周血NK细胞比例不仅是胃癌患者的辅助诊断标记物,而且还和胃癌的恶性表型相关。Objective:To investigate the changes and clinical significance of lymphocyte subsets in peripheral blood of patients with gastric cancer.Methods:Peripheral blood samples from 20 healthy volunteers,20 patients with gastric ulcer and 100 patients with gastric cancer were collected.The ratio of T cells including CD3^+,CD4^+,CD8^+,Tregs,natural killer(NK)cells and B cells(CD19^+)in peripheral blood were detected by flow cytometry.Combining with clinical data,the receiver operating characteristic(ROC)curve was used to analyze the diagnostic cutoff value of NK cell ratio.Results:The percentage of NK cells in peripheral blood of patients with gastric cancer before operation was significantly higher than that of patients with gastric ulcer and healthy people(P<0.05),but there was no significant difference in other peripheral blood lymphocyte subsets(P>0.05).The percentage of NK cells in peripheral blood was also correlated with T stage,N stage,TNM stage and differentiation level of gastric cancer(P<0.05).ROC curve analysis showed that the diagnostic threshold of NK cell ratio in peripheral blood in gastric cancer was 11.61%.The diagnostic sensitivity and specificity of this threshold were 88.0%and 80.0%respectively.Conclusion:The ratio of NK cells in peripheral blood can not only be used as an early diagnostic marker for gastric cancer,but also be related to the malignant phenotype of gastric cancer.

关 键 词：胃癌 淋巴细胞亚群 NK细胞 诊断 

分 类 号：R735.2[医药卫生—肿瘤]