CAJ | 학술논문

目的：体外检测卵巢癌患者血中CA125对细胞免疫功能的影响。方法收集2012年5月至2013年6月北京协和医院符合诊断标准的卵巢癌患者58例，按CA125浓度分为3组；同时收集良性妇科疾病患者20例及体检正常的健康者20名作为对照。应用细胞培养、酶联免疫吸附法、酶联免疫斑点（ enzyme-linked immunospot， ELISPOT）等实验，观察体外刺激健康人淋巴细胞产生γ-干扰素（ interferon-γ， IFN-γ）的能力，判断 CA125对机体细胞免疫状态的影响。结果在卵巢癌患者中，随CA125水平升高，淋巴细胞绝对值及百分比值呈逐渐下降趋势。高浓度CA125卵巢癌患者的血清与植物血凝素共同刺激健康者混合淋巴细胞后，培养上清液中IFN-γ的含量[（36.16±16.89） ng/ml]较阳性对照组和低浓度CA125组[分别为（45.68±18.01）和（46.22±19.30） ng/ml]显著降低（P＜0.05）； ELISPOT结果显示高浓度和中浓度CA125（斑点数均值分别为108.2和371.6）对细胞免疫抑制功能与健康对照组和良性疾病组（斑点数均值分别为573.0和523.0）比较，差异均有统计学意义（P＜0.01， P＜0.05）；而去除血清中CA125后，对细胞免疫抑制作用明显减弱。结论卵巢癌患者体内的CA125水平与淋巴细胞的数量、活性及其产生细胞因子的活性呈负相关关系。 CA125除作为与卵巢癌相关的标志物外，还可能是一种细胞免疫抑制因子。
목적：체외검측란소암환자혈중CA125대세포면역공능적영향。방법수집2012년5월지2013년6월북경협화의원부합진단표준적란소암환자58례，안CA125농도분위3조；동시수집량성부과질병환자20례급체검정상적건강자20명작위대조。응용세포배양、매련면역흡부법、매련면역반점（ enzyme-linked immunospot， ELISPOT）등실험，관찰체외자격건강인림파세포산생γ-간우소（ interferon-γ， IFN-γ）적능력，판단 CA125대궤체세포면역상태적영향。결과재란소암환자중，수CA125수평승고，림파세포절대치급백분비치정축점하강추세。고농도CA125란소암환자적혈청여식물혈응소공동자격건강자혼합림파세포후，배양상청액중IFN-γ적함량[（36.16±16.89） ng/ml]교양성대조조화저농도CA125조[분별위（45.68±18.01）화（46.22±19.30） ng/ml]현저강저（P＜0.05）； ELISPOT결과현시고농도화중농도CA125（반점수균치분별위108.2화371.6）대세포면역억제공능여건강대조조화량성질병조（반점수균치분별위573.0화523.0）비교，차이균유통계학의의（P＜0.01， P＜0.05）；이거제혈청중CA125후，대세포면역억제작용명현감약。결론란소암환자체내적CA125수평여림파세포적수량、활성급기산생세포인자적활성정부상관관계。 CA125제작위여란소암상관적표지물외，환가능시일충세포면역억제인자。
Objective To detect the effects of CA 125 on cellular immune function of the ovarian cancer ( OC) patients in vitro.Methods Totally 58 patients with confirmed OC in our hospital from May 2012 to June 2013 were divided into three groups based on the CA 125 levels.Meanwhile, 20 healthy subjects (control group) and 20 patients with benign gynecological diseases ( benign diseases group ) were also included .The in vitro abil-ity of healthy human lymphocytes in secreting interferon-γ( IFN-γ) under the stimulation of phytohemagglutinin ( PHA) was observed by cell culture , enzyme-linked immunosorbent assay (ELISA) and enzyme-linked immuno-spot (ELISPOT).Results In OC patients, the count and percentage of lymphocytes decreased gradually with elevated levels of CA 125 .The concentration of IFN-γin the supernatant of cultured lymphocytes from healthy in-dividuals decreased significantly under the stimulation of PHA and high concentration of CA 125 [(36.16 ± 16.89 ) ng/ml] compared with that of PHA alone [ (45.68 ±18.01 ) ng/ml] or PHA and low concentration of CA125 [(46.22 ±19.30)ng/ml] (both P<0.05).Compared with the control group (spots number 573.0) and the benign diseases group ( spots number 523.0 ) , the high ( spots number 108.2 ) and intermediate ( spots number 371.6 ) concentration of CA 125 had significant inhibitory effect on the cellular immune system , as detec-ted by ELISPOT ( P<0.01 , P<0.05 , respectively ) .After removal of CA125 from the serum by antibody , the inhibitory effect was weakened significantly .Conclusions The concentration of CA 125 in OC patient is nega-tively correlated with the number and activity of lymphocytes , in particular their abilities in releasing cytokines . CA125 is not only a biomarker of OC but also may serve as an immunosuppressive factor .