肺癌患者外周血CD4+CD25+调节性T细胞的检测及其临床意义

【关键词】  肺肿瘤
　　Measurement and significance of CD4+CD25+T cells in peripheral blood from patients with lung cancer
　　【Abstract】 AIM: To discuss the changes and significance of CD4+CD25+ T cells in peripheral blood from patients with lung cancer. METHODS: The changes of CD4+CD25+ T cells in peripheral blood from 60 patients with lung cancer were evaluated by flow cytometry,and compared with ones from 60 healthy volunteers. RESULTS: ① The population of CD4+CD25+ T cells in peripheral blood from patients with lung cancer accounted for (14.7±1.8)% of the total number of  CD4+ T lymphocytes,and the percentage was significantly higher than that of healthy volunteers ［ (6.5±1.4)%, P<0.05］; ② The number of CD4+CD25+T cells in peripheral blood from patients with lung cancer who had been treated with chemotherapy was lower than that of ones without chemotherapy［（14.7±1.8）% vs (6.8±1.4)%, P<0.05］; ③ The expression of CD4+CD25+T cells was higher in peripheral blood from patients with lung cancer of the higher histopathological grade,farther metastasis and poorer differentiation. CONCLUSION: The CD4+CD25+ regulatory T cells in peripheral blood from patients with lung cancer is significantly increased in comparison with healthy subjects. It may be responsible for immune suppression in lung cancer. The change of its expression will provide a clinical evidence for judging the curative effect.
　　【Keywords】 Lung neoplasms;  CD4+CD25+ T cells; flow cytometry
　　【摘要】 目的： 探讨肺癌患者外周血中CD4+CD25+调节性T细胞的变化及意义. 方法： 采用流式细胞技术检测60例肺癌患者外周血中CD4+CD25+调节性T细胞的变化，并与健康对照组进行比较.  结果： ① 肺癌患者外周血中CD4+CD25+调节性T细胞占CD4+T淋巴细胞总数高于健康对照者［（14.7±1.8）% vs (6.5±1.4)%, P<0.05］；② 化疗前肺癌患者外周血中CD4+CD25+T细胞明显高于化疗后［(14.7±1.8)% vs (6.8±1.4)%, P<0.05］；③ 同时发现肺癌患者恶性程度越高，转移及分化程度低者CD4+CD25+T的表达水平越高，其预后也越差. 结论：肺癌患者外周循环血中CD4+CD25+T细胞水平较高，可能与肺癌患者免疫功能受损有关，可作为评估肺癌患者预后的一项指标.
 
　　【关键词】  肺肿瘤；CD4+CD25+调节性T细胞;流式细胞术
　　0引言
　　肿瘤的发生、发展与机体的免疫监视机能密切相关. T淋巴细胞不仅是细胞免疫的效应细胞，而且在调节免疫反应中起着重要作用. 近年研究发现，人体内有一个具有独特免疫调节功能的T细胞亚群CD4+CD25+调节性T细胞，不仅能抑制自身免疫性疾病的发生，还可能参与肿瘤免疫的调节. 在人类健康个体的外周循环血中CD4+CD25+T细胞占总CD4+T细胞的5%~10%［1-3］,而在乳腺癌、胰腺癌等肿瘤患者的外周血中，这种调节性T细胞高达13.2%~16.6%［4］. 而且肿瘤恶性程度越高，CD4+CD25+T细胞水平越高，其预后也越差［5］. CD4+CD25+T细胞在人体内的表达水平与肿瘤的关系已成为目前研究的热点，但有关CD4+CD25+T细胞的表达与肺癌关系的研究报道较少,我们探讨了肺癌患者外周血CD4+CD25+T细胞水平与肺癌的关系及其临床意义.
　　1对象和方法
　　1.1对象肺癌患者60（男42，女18）例，均经病理学或细胞学证实，年龄33~74（54.0±13.2）岁. 组织学类型及分级：鳞癌17例、腺癌15例、小细胞未分化癌28例；根据国际抗癌协会标准进行临床分期：Ⅲ期29例、Ⅳ期31例；组织分级：高分化15例、中分化21例、低分化24例. 正常对照组：健康献血者60（男35，女