河北医学
河北醫學
하북의학
HEBEI MEDICINE
2009年
9期
1025-1028
,共4页
结直肠肿瘤%调节性T细胞%T淋巴细胞亚群%流式细胞仪
結直腸腫瘤%調節性T細胞%T淋巴細胞亞群%流式細胞儀
결직장종류%조절성T세포%T림파세포아군%류식세포의
Colorectal carcinoma%Regulatory T cells%T Lymphocyte subsets%Flow cytometer
目的:通过分析结直肠癌患者手术前后外周血CD4+CD25+T细胞水平与直肠癌患者细胞免疫状态、生物学特征的联系,以及手术对外周血CD4+CD25+T细胞水平变化的影响,评价结直肠癌患者机体细胞免疫功能状态及其临床意义.方法:收集我院胃肠外科2005年2月至2006年3月结直肠癌患者38例、结直肠良性疾病者28例,健康体检者13例,采用流式细胞仪检测外周血T淋巴细胞亚群、CD4+CD25+T细胞分布情况,以及检测结直肠癌患者术后1周、术后1月外周血CD4+CD25+T细胞水平,分析结直肠癌患者外周血CD4+CD25+T细胞水平与患者细胞免疫状态、生物学特征的联系,以及手术对外周血CD4+CD25+T细胞水平变化的影响.结果:结直肠癌患者术前外周血CD4+CD25+调节性T细胞水平(16.54±6.51)%,明显高于良性组(9.37±3.91)%和健康组(9.83±4.25)%(P<0.05),良性组和健康组差异无统计学意义(P<0.05).结直肠癌外周血T淋巴细胞中CD4/CD8比值、CD4+和NK细胞水平低于结直肠良性疾病组和健康组(P<0.05).结直肠癌组术前CD4+CD25+T细胞表达水平与性别、年龄、肿瘤部位、分化程度和Dukes分期等生物因素无联系.结直肠癌经根治或姑息术切除肿瘤,减少瘤负1个月后,外周血CD4+CD25+调节性T细胞水平较术前、术后1周明显下降,而术后1周与术前比较无明显统计学差异.结论:结直肠癌患者术前外周血CD4+CD25+调节性T细胞水平明显升高,可能是机体免疫功能受抑制的重要机制.结直肠癌患者外周血CD4+CD25+调节性T细胞水平变化与患者性别、年龄、肿瘤部位、肿瘤细胞分化程度、临床分期无联系.手术切除肿瘤后1个月,外周血CD4+CD25+调节性T细胞水平较术前明显下降,而CD4+CD25-T细胞水平较术前明显升高,表明减少瘤负后机体免疫抑制减轻,免疫功能有所恢复.外周血CD4+CD25+调节性T细胞可能成为结直肠癌患者机体免疫状态临床监测的指标.
目的:通過分析結直腸癌患者手術前後外週血CD4+CD25+T細胞水平與直腸癌患者細胞免疫狀態、生物學特徵的聯繫,以及手術對外週血CD4+CD25+T細胞水平變化的影響,評價結直腸癌患者機體細胞免疫功能狀態及其臨床意義.方法:收集我院胃腸外科2005年2月至2006年3月結直腸癌患者38例、結直腸良性疾病者28例,健康體檢者13例,採用流式細胞儀檢測外週血T淋巴細胞亞群、CD4+CD25+T細胞分佈情況,以及檢測結直腸癌患者術後1週、術後1月外週血CD4+CD25+T細胞水平,分析結直腸癌患者外週血CD4+CD25+T細胞水平與患者細胞免疫狀態、生物學特徵的聯繫,以及手術對外週血CD4+CD25+T細胞水平變化的影響.結果:結直腸癌患者術前外週血CD4+CD25+調節性T細胞水平(16.54±6.51)%,明顯高于良性組(9.37±3.91)%和健康組(9.83±4.25)%(P<0.05),良性組和健康組差異無統計學意義(P<0.05).結直腸癌外週血T淋巴細胞中CD4/CD8比值、CD4+和NK細胞水平低于結直腸良性疾病組和健康組(P<0.05).結直腸癌組術前CD4+CD25+T細胞錶達水平與性彆、年齡、腫瘤部位、分化程度和Dukes分期等生物因素無聯繫.結直腸癌經根治或姑息術切除腫瘤,減少瘤負1箇月後,外週血CD4+CD25+調節性T細胞水平較術前、術後1週明顯下降,而術後1週與術前比較無明顯統計學差異.結論:結直腸癌患者術前外週血CD4+CD25+調節性T細胞水平明顯升高,可能是機體免疫功能受抑製的重要機製.結直腸癌患者外週血CD4+CD25+調節性T細胞水平變化與患者性彆、年齡、腫瘤部位、腫瘤細胞分化程度、臨床分期無聯繫.手術切除腫瘤後1箇月,外週血CD4+CD25+調節性T細胞水平較術前明顯下降,而CD4+CD25-T細胞水平較術前明顯升高,錶明減少瘤負後機體免疫抑製減輕,免疫功能有所恢複.外週血CD4+CD25+調節性T細胞可能成為結直腸癌患者機體免疫狀態臨床鑑測的指標.
목적:통과분석결직장암환자수술전후외주혈CD4+CD25+T세포수평여직장암환자세포면역상태、생물학특정적련계,이급수술대외주혈CD4+CD25+T세포수평변화적영향,평개결직장암환자궤체세포면역공능상태급기림상의의.방법:수집아원위장외과2005년2월지2006년3월결직장암환자38례、결직장량성질병자28례,건강체검자13례,채용류식세포의검측외주혈T림파세포아군、CD4+CD25+T세포분포정황,이급검측결직장암환자술후1주、술후1월외주혈CD4+CD25+T세포수평,분석결직장암환자외주혈CD4+CD25+T세포수평여환자세포면역상태、생물학특정적련계,이급수술대외주혈CD4+CD25+T세포수평변화적영향.결과:결직장암환자술전외주혈CD4+CD25+조절성T세포수평(16.54±6.51)%,명현고우량성조(9.37±3.91)%화건강조(9.83±4.25)%(P<0.05),량성조화건강조차이무통계학의의(P<0.05).결직장암외주혈T림파세포중CD4/CD8비치、CD4+화NK세포수평저우결직장량성질병조화건강조(P<0.05).결직장암조술전CD4+CD25+T세포표체수평여성별、년령、종류부위、분화정도화Dukes분기등생물인소무련계.결직장암경근치혹고식술절제종류,감소류부1개월후,외주혈CD4+CD25+조절성T세포수평교술전、술후1주명현하강,이술후1주여술전비교무명현통계학차이.결론:결직장암환자술전외주혈CD4+CD25+조절성T세포수평명현승고,가능시궤체면역공능수억제적중요궤제.결직장암환자외주혈CD4+CD25+조절성T세포수평변화여환자성별、년령、종류부위、종류세포분화정도、림상분기무련계.수술절제종류후1개월,외주혈CD4+CD25+조절성T세포수평교술전명현하강,이CD4+CD25-T세포수평교술전명현승고,표명감소류부후궤체면역억제감경,면역공능유소회복.외주혈CD4+CD25+조절성T세포가능성위결직장암환자궤체면역상태림상감측적지표.
Objective: Study has been shown that CD4+ CD25+ regulatory T cells play a key role in the maintenance of peripheral self-tolerance and perform the function with an active way and it is of great significance in the anti-tumor therapy. To investigate the relations between the CD4+ CD25+regulatory T cells and the condition of cellular immunity, the effect of biological characters of the CRC patients. Method: The specimens of 38 CRC patients, 28 colorectal benign disease patients and 13 healthy adults were collected from Feb. 2005 to Mar. 2006 in our hospital. Flow cytometry was used to detected T lymphocyte subsets and the CD4+ CD25+regulatory T cells in the peripheral blood of CRC patients at the 7th day and 1 month after operation. In order to investigate the relations between the CD4+CD25+regulatory T ceils and the condition of cellular immunity, the effect of clinical characters of the CRC patients. Result: The proportion of CD4+T cells, NK cells and the ratio of CD4/CD8 in the group of CRC patients before operation were significantly less than those of benign and healthy group ( P < 0.05 ). There were no difference between benign and healthy group ( P < 0.05 ). No difference was found in the specimens in the percentages of CD4+CD25 +T cells in CRC patients before resection compared with sex, age, tumor position, cell differentiation and Dukes stage. With regard to the peripheral blood CD4+ CD25+ T cells of CRC patients after radical correction or palliation, the proportion of CD4+ CD25+ T cells at the 1 month after operation was significantly less than that level before resection or that at the 7th day after operation. No difference was found in the percentage of CD4+CD25+T cell between the one before operation and the one at the 7th day after operation. The proportion of CD4 + CD25 + T cells at the lat month after operation was signigicantly higher than that level before resection and that at the 7th day after operation. There were no difference in the percentage of CD4 + CD25 +Tcells between the one at the 7th day after operation. Conclusion: The proportion of CD4+CD25+T cells in peripheral blood of CRC patients increase , it may be one of the important reasons of immune suppression in CRC. In compare with sex, age, tumor position, cell differentiation and Dukes stage before resection, there is no difference in the percentage of CD4+CD25+T cells in CRC patients. In compare with the proportion before resection, at the 1 st month after operation, the proportion of CD4+ CD25 + T cells descends and the proportion of CD4+ CD25+ T cells rises. It indicated that the immune suppression was breakdown and the functional disorder of immune system was recovering after operation. The proportion of CD4+CD25 +T cells in peripheral blood may become a good cellular immunological index of CRC patients in clinical monitor.