高级别浆液性卵巢癌腹水淋巴细胞组分及其与临床特征的相关性研究  

The composition of ascites lymphocytes in high-grade serous ovarian cancer and its correlation with clinical features

作　　者：何天慧 张洁[2] 尹忠楠 张曦[1] 李圆[1] 吴郁[1] 李华军 梁华茂[1] 薛丽香[2] 郭红燕[1] He Tianhui;Zhang Jie;Yin Zhongnan;Zhang Xi;Li Yuan;Wu Yu;Li Huajun;Liang Huamao;Xue Lixiang;Guo Hongyan(Department of Obstetrics and Gynecology,Peking University Third Hospital,Beijing 100083,China;Center of Basic Medical Research,Institute of Medical Innovation and Research,Peking University Third Hospital,Beijing 100083,China)

机构地区：[1]北京大学第三医院妇产科,北京100083 [2]北京大学第三医院医学创新研究所基础医学研究中心,北京100083

出　　处：《中华医学杂志》2021年第30期2375-2381,共7页National Medical Journal of China

基　　金：北京市自然科学基金(J200015);首都卫生发展科研专项(2020-2-4098);北京大学第三医院临床重点项目人才项目C类(BYSYZD2019034)。

摘　　要：目的分析高级别浆液性卵巢癌(HGSOC)腹水淋巴细胞组分及其与临床特征的相关性。方法选取2019年7月至2020年12月于北京大学第三医院妇产科就诊的初治HGSOC患者59例,年龄为(58±11)岁,分别收集腹水及腹腔冲洗液。通过流式细胞术,检测其中T、B、自然杀伤(NK)细胞及其亚群的比例,并分析其与患者临床特征的相关性。结果59例病例中有腹水者48例(81.4%),无腹水者11例(18.6%),腹水中的CD3^(+)T(70.2%±15.6%比78.1%±6.7%,P=0.014)、CD8^(+)T(38.3%±11.2%比47.7%±10.1%,P=0.014)和CD16^(-)CD56^(bright) NK[2.0%(0.8%,3.6%)比4.2%(1.5%,7.1%),P=0.026]细胞占比低于无腹水患者的腹腔冲洗液,而CD16^(+)CD56^(dim) NK细胞增多[6.8%(2.8%,15.7%)比2.6%(1.6%,4.3%),P=0.008]。与腹水量<1000 ml的患者相比,腹水量≥1000 ml的患者腹水中CD16^(-)CD56^(bright) NK细胞增多[3.1%(1.2%,3.9%)比0.8%(0.4%,2.3%),P=0.002]。年龄与腹水中CD4^(+)T细胞水平(r=0.332,P=0.021)和CD4^(+)T/CD8^(+)T比值(r=0.379,P=0.008)均呈正相关。治疗疗效不佳的患者,腹水中CD4^(+)T细胞多于疗效较好的患者(64.7%±4.2%比48.3%±11.7%,P=0.002)。结论初治HGSOC患者腹水的形成会影响腹腔微环境中淋巴细胞的组分,其与患者年龄、癌症进展和治疗疗效存在相关性。Objective To explore the composition of ascites lymphocytes in high-grade serous ovarian carcinoma(HGSOC)and its correlation with clinical features.Methods A total of 59 newly-diagnosed HGSOC patients,aged(58±11)years old,who were treated at the Department of Obstetrics and Gynecology of Peking University Third Hospital from July 2019 to December 2020 were included,collecting ascites and peritoneal irrigation fluid respectively.Detect the proportion of T,B,NK cell and its subpopulations by flow cytometry,and analyze its correlation with the clinical characteristics of patients.Results Among 59 patients,48 patients(81.4%)had ascites,and 11 patients(18.6%)had no ascites.Compared with the peritoneal irrigation fluid,the CD3^(+)T(70.2%±15.6%vs 78.1%±6.7%,P=0.014),CD8^(+)T(38.3%±11.2%vs 47.7%±10.1%,P=0.014)and CD16^(-)CD56^(bright)NK[2.0%(0.8%,3.6%)vs 4.2%(1.5%,7.1%),P=0.026]cells were significantly decreased in the ascites,while the CD16^(+)CD56^(dim)NK cells was significantly increased[6.8%(2.8%,15.7%)vs 2.6%(1.6%,4.3%),P=0.008].In patients with ascites volume≥1000 ml,CD16^(-)CD56^(bright)NK cells were significantly increased than those ascites volume<1000 ml[3.1%(1.2%,3.9%)vs 0.8%(0.4%,2.3%),P=0.002].Age was significantly positively correlated with the level of CD4^(+)T cells(r=0.332,P=0.021)and the ratio of CD4^(+)T/CD8^(+)T(r=0.379,P=0.008)in ascites.In ascites from patients with poor response to treatment,the proportion of CD4^(+)T cells was increased significantly than those with better response(64.7%±4.2%vs 48.3%±11.7%,P=0.002).Conclusion The formation of ascites in newly diagnosed high-grade serous epithelial ovarian cancer patients would affect the lymphocyte composition in the abdominal cavity microenvironment,which is related to the patient′s age,cancer progression and treatment response.

关 键 词：腹水 高级别浆液性卵巢癌 淋巴细胞 治疗反应性 

分 类 号：R737.31[医药卫生—肿瘤]