CAJ | 학술논문

目的探讨健康者、慢性胃炎、胃上皮内瘤变及胃癌患者外周血髓源抑制细胞( MDSC)比例变化与细胞免疫功能之间的关联.方法收集2011年2月至7月间129份外周血标本,包括32例健康志愿者、48例慢性胃炎患者、27例胃上皮内瘤变患者及22例胃癌患者.采用流式细胞术对外周血的MDSC、T淋巴细胞亚群、调节性T细胞(Treg)的比例进行检测.采用单因素方差分析和Pearson及Spearman相关分析进行统计学处理.结果胃癌组外周血中MDSC、调节性T细胞(Treg)、CD8+T淋巴细胞的比例最高[(9.63±3.24)％,(10.03±1.26)％,(69.45±3.42)％],健康组中最低[(0.92±0.33)％,(4.12±0.99)％,(32.35±4.83)％],胃上皮内瘤变组[(5.13±1.30)％,(7.54±0.79)％,(53.26±4.30)％)]低于胃癌组但高于慢性胃炎组[(2.76±0.64)％,(6.28±0.61)％,(42.37±4.02)％]；各组间差异均有统计学意义(F=24.85、20.88、37.84,P值均＜0.05).相反,CD4+T淋巴细胞的比例在健康组最高,为(65.10±4.10)％,在慢性胃炎组(55.15％±4.00％)、胃上皮内瘤变组(42.23％±3.91％)和胃癌组(26.84％±3.69％)中依次降低,各组间差异有统计学意义(F=46.80,P＜0.05).外周血MDSC比例与胃癌TNM分期呈正相关(r=0.856,P＜0.01).外周血MDSC比例与Treg比例呈正相关(r=0.862,P＜0.01),与CD4+/CD8+T淋巴细胞比值呈负相关(r=-0.768,P＜0.01).结论外周血MDSC比例的升高与人体细胞免疫功能密切相关,可能在慢性胃炎演变至胃癌的肿瘤逃逸过程中起至关重要的作用.
목적 탐토건강자、만성위염、위상피내류변급위암환자외주혈수원억제세포( MDSC)비례변화여세포면역공능지간적관련.방법 수집2011년2월지7월간129빈외주혈표본,포괄32례건강지원자、48례만성위염환자、27례위상피내류변환자급22례위암환자.채용류식세포술대외주혈적MDSC、T림파세포아군、조절성T세포(Treg)적비례진행검측.채용단인소방차분석화Pearson급Spearman상관분석진행통계학처리.결과 위암조외주혈중MDSC、조절성T세포(Treg)、CD8+T림파세포적비례최고[(9.63±3.24)％,(10.03±1.26)％,(69.45±3.42)％],건강조중최저[(0.92±0.33)％,(4.12±0.99)％,(32.35±4.83)％],위상피내류변조[(5.13±1.30)％,(7.54±0.79)％,(53.26±4.30)％)]저우위암조단고우만성위염조[(2.76±0.64)％,(6.28±0.61)％,(42.37±4.02)％]；각조간차이균유통계학의의(F=24.85、20.88、37.84,P치균＜0.05).상반,CD4+T림파세포적비례재건강조최고,위(65.10±4.10)％,재만성위염조(55.15％±4.00％)、위상피내류변조(42.23％±3.91％)화위암조(26.84％±3.69％)중의차강저,각조간차이유통계학의의(F=46.80,P＜0.05).외주혈MDSC비례여위암TNM분기정정상관(r=0.856,P＜0.01).외주혈MDSC비례여Treg비례정정상관(r=0.862,P＜0.01),여CD4+/CD8+T림파세포비치정부상관(r=-0.768,P＜0.01).결론 외주혈MDSC비례적승고여인체세포면역공능밀절상관,가능재만성위염연변지위암적종류도일과정중기지관중요적작용.
Objective To investigate the correlation between the ratio change of circulating myeloid-derived suppressor cells (MDSCs) and cellular immune function in healthy volunteers,chronic gastritis patients,gastric intraepithelial neoplasia patients and gastric cancer patients.Methods From February 2011 to July 2011,129 peripheral blood samples were collected,including 32 healthy volunteers,48 chronic gastritis patients,27 gastric intraepithelial neoplasia patients and 22 gastric cancer patients.The percentages of peripheral blood MDSC,T lymphocyte subsets and regulatory T cells (Treg) were determined by flow cytometry.The data were analyzed by one way analysis of variance,pearson and spearman correlation.Results The percentages of circulating MDSC,CD8+ T lymphocyte and Treg were highest in gastric cancer patients (9.63％±3.24％,10.03％ ± 1.26％,69.45％±3.42％) and lowest in healthy volunteers (0.92％±0.33％,4.12％ ±0.99％,32.35％ ±4.83％).Those of gastric intraepithelial neoplasia patients (5.13％ ± 1.30％,7.54％ ± 0.79％,53.26％±4.30％) were lower than gastric cancer patients but higher than chronic gastritis patients (2.76％ ±0.64％,6.28％ ±0.61％,42.37％ ±4.02％).The differences among each groups were statistically significant (F=24.85,20.88,37.84,all P＜0.05).However,the percentage of circulating CD4+T lymphocyte was highest in healthy volunteers (65.10％±4.10％),55.15％ ± 4.00％ in chronic gastritis group,42.23％ ± 3.91％ in gastric intraepithelial neoplasia group,and lowest in gastric cancer group (26.84％ ± 3.69％).The differences among each groups were statistically significant (F=46.80,P＜0.05).A significant correlation between circulating MDSC and TNM stages of gastric cancer was also observed (r=0.856,P＜0.01).The percentage of circulating MDSC was positively correlated with Treg percentage (r =0.862,P ＜ 0.01),and negatively correlated with CD4+/CD8+ ratio (r=-0.768,P＜0.01).Conclusion The increase of MDSC percentage in peripheral blood is correlated with human cellular immune function,which might play an important role in the tumor immune evasion during the development of gastric cancer.