非小细胞肺癌患者癌组织免疫微环境中Th1、Th2、Th17的表达水平及意义  

Expression Levels and Significance of Th1,Th2 and Th17 in the Immune Microenvironment of Cancer Tissues of Patients with Non-small Cell Lung Cancer

作　　者：毛英[1] 刘黎[1] 张匠 杨帆[1] 王晓华[1] MAO Ying;LIU Li;ZHANG Jiang;YANG Fan;WANG Xiao-hua(Department of Oncology,Suining Central Hospital,Suining,Sichuan 629000,China)

机构地区：[1]遂宁市中心医院肿瘤科,四川遂宁629000

出　　处：《临床误诊误治》2021年第1期77-82,共6页Clinical Misdiagnosis & Mistherapy

基　　金：四川省卫生和计划生育委员会科研课题(普及应用项目)(16PJ521)。

摘　　要：目的探讨非小细胞肺癌(non small cell lung cancer,NSCLC)患者癌组织免疫微环境中辅助性T淋巴细胞(Th)1、Th2、Th17的表达水平及意义。方法选取NSCLC 64例,比较治疗前癌组织与癌旁正常组织细胞因子干扰素-γ(IFN-γ)、白细胞介素(IL)-4、IL-17水平和Th1、Th2、Th17表达水平,分析NSCLC临床特征与治疗前癌组织Th1、Th2、Th17表达水平的关系(根据中位数分为高表达组与低表达组各32例),比较治疗前和化学治疗1~4疗程末的外周血Th1、Th2、Th17表达水平。结果治疗前,NSCLC患者癌组织IFN-γ水平低于癌旁正常组织,IL-4和IL-17水平高于癌旁正常组织,差异有统计学意义(P<0.01)。NSCLC患者癌组织Th1表达水平低于癌旁正常组织,Th2和Th17表达水平高于癌旁正常组织,差异有统计学意义(P<0.01)。治疗前TNM分期Ⅲ期NSCLC患者癌组织Th1低表达、Th2和Th17高表达比例明显高于TNM分期Ⅰ期和Ⅱ期NSCLC患者,差异有统计学意义(P<0.05或P<0.01)。治疗前腺癌NSCLC患者癌组织Th2和Th17高表达比例明显高于鳞癌NSCLC患者,差异有统计学意义(P<0.05或P<0.01)。随着化学治疗疗程的增加,NSCLC患者外周血Th1表达水平逐渐升高,Th2与Th17表达水平逐渐下降,与治疗前比较差异均有统计学意义(P<0.05或P<0.01)。结论NSCLC患者癌组织存在Th1、Th2和Th17免疫微环境平衡失调,这可能是患者免疫功能下降的原因,有效化学治疗可改善患者免疫功能,检测患者Th1、Th2、Th17表达情况对免疫功能评估有重要意义。Objective To investigate the expression levels and significance of T-helper lymphocyte 1(Th1),Th2 and Th17 in the immune microenvironment of cancer tissues of patients with non-small cell lung cancer(NSCLC).Methods Sixty-four patients with NSCLC were selected as the research subjects.The levels of interferon-γ(IFN-γ),cytokines interleukin(IL)-4 and IL-17,and expression levels of Th1,Th2 and Th17 in cancer tissues and normal adjacent tissues were compared before treatment.The relationship between clinical characteristics of NSCLC and expression levels of Th1,Th2 and Th17 in cancer tissues before treatment was analyzed[According to median level,they were divided into high expression group(n=32)and low expression group(n=32)].The expression levels of Th1,Th2 and Th17 before treatment and at the end of 1-4 courses of chemotherapy were compared.Results IFN-γlevels in cancer tissues of NSCLC patients were lower than those in normal adjacent tissues,while IL-4 and IL-17 levels were higher than those in normal adjacent tissues(P<0.01).The expression level of Th1 in cancer tissues of NSCLC patients was lower than that in normal adjacent tissues,while the expression levels of Th2 and Th17 were higher than those in normal adjacent tissues(P<0.01).The proportions of Th1 low expression,Th2 and Th17 high expression in cancer tissues of TNM stageⅢwere significantly higher than those in stageⅠandⅡ(P<0.05 or P<0.01).The proportions of Th2 and Th17 high expression in cancer tissues of NSCLC patients with adenocarcinoma were significantly higher than those with squamous cell carcinoma(P<0.05 or P<0.01).With the increase of chemotherapy course,the expression level of Th1 in peripheral blood of NSCLC patients was increased,and the expression levels of Th2 and Th17 were decreased,compared with those before treatment(P<0.05 or P<0.01).Conclusion There is imbalance of Th1,Th2 and Th17 immune microenvironment in cancer tissues of patients with NSCLC,which may be the reason for decline of patients'immune function.Effective chemot

关 键 词：癌 非小细胞肺 白细胞介素-1 白细胞介素-17 干扰素-γ 辅助性T淋巴细胞1 辅助性T淋巴细胞2 辅助性T淋巴细胞17 

分 类 号：R734.2[医药卫生—肿瘤] R730.26[医药卫生—临床医学]