CAJ | 학술논문

目的：检测肺癌患者外周血中Thl、Th 2型细胞因子及NK细胞表面活化性受体NKG2 D的表达水平，探讨其临床意义。方法选择64例初发未治疗的肺癌患者为病例组，体检中心健康人60例为对照组，分别用CBA法检测两组外周血Thl细胞因子及Th 2细胞因子，流式细胞仪检测两组外周血NK细胞表面NKG2 D含量。分析上述指标的不同表达水平在肺癌患者中的意义。结果（1）与正常对照组相比，病例组外周血中IL-2、IFN-γ、IL-10、表达水平低于对照组（P<0.05），IL-4、IL-6及TNF-α水平高于对照组（P<0.05），NKG2 D水平低于对照组（P<0.05）；（2）I I-IV 期肺癌患者IL-2、IFN-γ及NKG2 D的表达明显低于I-I 期患者，IL-4的表达则相反；（3）在不同病理分型中，鳞癌、腺癌及小细胞癌患者外周血中IFN-γ表达差异有统计学意义（F=3.993， P<0.024），其余指标表达差异无统计学意义；（4）TNF-α在男性患者中表达高于女性患者（t=2.087，P=0.041），其余指标差异无统计学意义；（5）所检测指标在吸烟与否的患者间差异无统计学意义；（6）在对照组中，IL-2与IL-4、IL-10、TNF-α呈正相关；在病例组中，IL-2与IL-4、IFN-γ、TNF-α呈正相关，IL-4与IL-6、IL-10、IFN-γ、TNF-α呈正相关，IL-6与IL-10正相关，IFN-γ与TNF-α呈正相关，上述结果差异均有统计学意义（P<0.05）。结论（1）肺癌患者Thl型细胞因子及NKG2 D在外周血中低表达，Th 2型细胞因子高表达，且与肺癌的分期有关；（2）Thl/Th 2细胞因子的失衡及NKG2 D的下调导致患者免疫功能失调，是肺癌发生发展的重要原因；(3)检测上述指标有助于了解患者的免疫功能状态，可为临床肿瘤的生物免疫治疗提供依据。
목적：검측폐암환자외주혈중Thl、Th 2형세포인자급NK세포표면활화성수체NKG2 D적표체수평，탐토기림상의의。방법선택64례초발미치료적폐암환자위병례조，체검중심건강인60례위대조조，분별용CBA법검측량조외주혈Thl세포인자급Th 2세포인자，류식세포의검측량조외주혈NK세포표면NKG2 D함량。분석상술지표적불동표체수평재폐암환자중적의의。결과（1）여정상대조조상비，병례조외주혈중IL-2、IFN-γ、IL-10、표체수평저우대조조（P<0.05），IL-4、IL-6급TNF-α수평고우대조조（P<0.05），NKG2 D수평저우대조조（P<0.05）；（2）I I-IV 기폐암환자IL-2、IFN-γ급NKG2 D적표체명현저우I-I 기환자，IL-4적표체칙상반；（3）재불동병리분형중，린암、선암급소세포암환자외주혈중IFN-γ표체차이유통계학의의（F=3.993， P<0.024），기여지표표체차이무통계학의의；（4）TNF-α재남성환자중표체고우녀성환자（t=2.087，P=0.041），기여지표차이무통계학의의；（5）소검측지표재흡연여부적환자간차이무통계학의의；（6）재대조조중，IL-2여IL-4、IL-10、TNF-α정정상관；재병례조중，IL-2여IL-4、IFN-γ、TNF-α정정상관，IL-4여IL-6、IL-10、IFN-γ、TNF-α정정상관，IL-6여IL-10정상관，IFN-γ여TNF-α정정상관，상술결과차이균유통계학의의（P<0.05）。결론（1）폐암환자Thl형세포인자급NKG2 D재외주혈중저표체，Th 2형세포인자고표체，차여폐암적분기유관；（2）Thl/Th 2세포인자적실형급NKG2 D적하조도치환자면역공능실조，시폐암발생발전적중요원인；(3)검측상술지표유조우료해환자적면역공능상태，가위림상종류적생물면역치료제공의거。
Objective To detect the levels of Th 1/Th 2 state and NK cell surface activating receptor NKG2 Ds expression on the preliminary of drifting of peripheral blood and discuss its clinical signiifcance in patients with lung cancer in different stages and classiifcation. Methods 64 cases of untreated patients with lung cancer were chosen as experimental group and 60 cases of healthy persons as control group, cytokines Thl and Th 2 cytokines in the peripheral blood of experimental group and control group in the CBA method and NKG2 D content of NK cell surface in peripheral blood were detected in the experimental group and control group.The differences of expression of all the indicators in the peripheral blood in lung cancer patients and controls were analyzed. Results The levels of IL-2、IFN-γ、IL-10 in the peripheral blood in patients with lung cancer are lower than the control groups (P<0.05), while the levels of IL-4、IL-6 and TNF-αare higher than control groups (P<0.05), The level of NK cell surface activating receptor NKG2 D is lower than the control group (P<0.05). The difference are statistically signiifcant. With the increasing of the TNM stages, the differences are becoming more and more obvious. The expression of IL-2,IFN-γand NKG2 D in patients of III/IV stages are lower while IL-4 is higher than I/II stages(P<0.05). The expression of IFN-γin patients with lung cancer have statistical difference with pathological classiifcation (F=3.993,P<0.024). The expression of TNF-αin male patients is higher than female(t=2.087,P<0.041).The expression of Thl, Th 2 cytokines, and NKG2 D in patients with lung cancer have no statistical difference with smoking status (P>0.05). In control group, IL-2 and IL-4,IL-10,TNF-αexpressed a positive correlation, in experimental group, IL-2 and IL-4,IFN-γ,TNF-αexpressed a positive correlation,IL-4 and IL-6,IL-10,IFN-γ, TNF-αexpress a positive correlation,IL-6 and IL-10 express a positive correlation,IFN-γand TNF-αexpressed a positive correlation,The difference were statistically signiifcant(P<0.05).Conclusion Compared with control group, cytokines Thl expression of the patients with lung cancer peripheral blood is lower and the Th 2 cytokine and the expression of NKG2 D in NK cell surface are higher, all that were associated with the stages of lung cancer;The imbalance of Thl/Th 2 ratio and NKG2 D lowering lead to the imbalance of immune function in patients, those were the important reasons of lung cancer development. Detections of the above indicators help to understand the patient's immune function and provide clinical the basis of comprehensive treatment of tumor.