外周血淋巴细胞在子宫颈高级别鳞状上皮内病变及早期子宫颈癌中的表达及其意义  

Expressions of peripheral blood lymphocytes in high-grade squamous intraepithelial lesions of the cervix and early cervical cancer and their significances

作　　者：张佳 令狐丽琴 赵瑞霞[1] 魏丽军[1] 郭勇峰[1] 王洁[1] 路娜 贾海霞 Zhang Jia;Linghu Liqin;Zhao Ruixia;Wei Lijun;Guo Yongfeng;Wang Jie;Lu Na;Jia Haixia(Department of Gynecology,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China;Shanxi Centre for Disease Control and Prevention,Taiyuan 030012,China;Department of Scientific Research,Shanxi Province Cancer Hospital,Shanxi Hospital Affiliated to Cancer Hospital,Chinese Academy of Medical Sciences,Cancer Hospital Affiliated to Shanxi Medical University,Taiyuan 030013,China)

机构地区：[1]山西省肿瘤医院中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院妇科,太原030013 [2]山西省疾病预防控制中心,太原030012 [3]山西省肿瘤医院、中国医学科学院肿瘤医院山西医院、山西医科大学附属肿瘤医院科研科,太原030013

出　　处：《肿瘤研究与临床》2023年第7期505-509,共5页Cancer Research and Clinic

基　　金：山西省自然科学基金(20210302124420)。

摘　　要：目的探讨子宫颈高级别鳞状上皮内病变(HSIL)及早期子宫颈癌患者外周血淋巴细胞的表达水平,并分析其与子宫颈癌临床病理特征的关系。方法回顾性分析2020年10月至2021年11月山西省肿瘤医院收治的65例HSIL及78例早期(2018年版国际妇产科联盟分期≤ⅡA期)子宫颈癌患者的临床资料,选择同时间段山西省肿瘤医院体检中心的31名健康体检者作为健康对照组。使用流式细胞仪检测所有受试者空腹外周血CD3+T细胞、CD4+T细胞、CD8+T细胞、NK细胞、NK/T细胞等免疫细胞的表达情况。结果HSIL组和早期子宫颈癌组CD3+T细胞、CD4+T细胞、CD4+/CD8+、NK细胞表达水平分别为71±8和73±9、39±7和41±9、1.5±0.5和1.5±0.6、16±7和16±9,均低于健康对照组的76±9、45±10、2.0±1.3、20±7(均P<0.05);HSIL组和早期子宫颈癌组CD8+T细胞表达水平分别为28±7、29±8,均高于健康对照组的24±7(均P<0.05)。早期子宫颈癌组总B细胞表达水平为10±4,低于健康对照组的12±3(P<0.05)。肿瘤长径>4 cm、有神经或脉管侵犯的早期子宫颈癌患者外周血CD3+T细胞表达水平分别为71±10、72±8,均低于肿瘤长径2~4 cm及≤2 cm、无神经或脉管侵犯者的72±8、75±8、78±7,而CD8+T细胞表达水平分别为32±8、35±4,均高于肿瘤长径2~4 cm及≤2 cm、无神经或脉管侵犯者的28±8、28±7、29±8(均P<0.05)。CD3+T细胞、总B细胞水平与肿瘤长径均呈负相关(均P<0.05),CD8+T细胞水平与肿瘤长径呈正相关(P<0.05);CD3+T细胞、NK细胞水平与神经或脉管侵犯均呈负相关(均P<0.05)。结论机体的免疫功能在子宫颈癌变进程的前期即发生变化,并与子宫颈癌肿瘤长径及神经或脉管侵犯相关。Objective To investigate the expression levels of peripheral blood lymphocytes in patients with high-grade squamous intraepithelial lesions(HSIL)of the cervix and early cervical cancer,and to analyze their correlation with the clinicopathological characteristics of cervical cancer.Methods The clinical data of 65 patients with HSIL and 78 patients with early cervical cancer(2018 International Federation of Gynecology and Obstetrics stage≤stageⅡA)treated in Shanxi Province Cancer Hospital from October 2020 to November 2021 were retrospectively analyzed,and 31 healthy people undergoing physical examination during the same period were treated as the healthy control group.The expressions of CD3+T cells,CD4+T cells,CD8+T cells,NK cells,NK/T cells and other immune cells in fasting peripheral blood of the patients were detected by using flow cytometry.Results The expression levels of CD3+T cells,CD4+T cells,CD4+/CD8+and NK cells were 71±8,39±7,1.5±0.5,16±7,respectively in HSIL group,and 73±9,41±9,1.5±0.6,16±9,respectively in early cervical cancer group,which were lower than those in the healthy control group(76±9,45±10,2.0±1.3,20±7)(all P<0.05).The expression levels of CD8+T cells was 28±7,29±8,respectively in HSIL group and early cervical cancer group,which were higher than those in the healthy control group(24±7)(all P<0.05).The expression level of total B cells in early cervical cancer group was lower than that in healthy control group(10±4 vs.12±3,P<0.05).The expression level of CD3+T cells in peripheral blood of early cervical cancer patients with tumor diameter>4 cm and nerve/vascular invasion was 71±10 and 72±8,which was lower than that of patients with tumor diameter 2-4 cm,≤2 cm and without nerve/vascular invasion(72±8,75±8,78±7);the expression level of CD8+T cell was 32±8 and 35±4,which was higher than that of patients with tumor diameter 2-4 cm,≤2 cm,and without nerve/vascular invasion(28±8,28±7,29±8)(all P<0.05).The levels of CD3+T cells and total B cells were negatively cor

关 键 词：宫颈肿瘤 淋巴细胞 子宫颈鳞状上皮内病变 免疫功能 

分 类 号：R737.33[医药卫生—肿瘤]