CAJ | 학술논문

目的通过研究肺癌患者外周血T淋巴细胞亚群与NK细胞的表达及动态变化,分析其与肺癌发生、发展的关系及其临床意义.方法运用流式细胞术检测66例肺癌患者(肺癌组)、60例肺结核患者(肺结核组)和60名健康人(健康对照组)外周血中CD+3、CD+3 CD+8、CD+3 CD+4、Th/Ts、CD+16CD+56的表达；肺癌组还检测了化疗前后第3、7和20天外周血CD+3、CD+3 CD+8、CD+3CD+4、Th/Ts、CD+16CD+56的表达.结果肺癌组CD+3、CD+3CD+4、Th/Ts、CD+16CD+56表达明显降低[(54.23±10.37)％、(34.23±8.03)％、1.35±0.20、(25.18±4.34)％],与肺结核组[(63.09±9.19)％、(39.46±12.74)％、1.51±0.41、(26.45±3.96)％]和健康对照组[(69.68±8.31)％、(42.31±13.29)％、1.89±0.48、(29.44±2.51)％]比较差异均有统计学意义(均P＜ 0.05)；CD+3CD+8表达三组间差异均无统计学意义(均P＞ 0.05).在化疗组中,化疗缓解组化疗后第3天CD+3、CD+3CD+4、Th/Ts和CD+16CD+56表达较化疗前均显著降低(均P＜0.01),而CD+3CD+8表达显著升高(P＜0.01)；第7天各项指标基本恢复到化疗前水平；第20天CD+3、CD+3CD+4、Th/Ts和CD+16CD+56表达较化疗前均显著升高(均P＜0.05),而CD+3CD+8表达显著降低(P＜0.05).化疗未缓解组化疗前后各项指标的表达差异均无统计学意义(均P＞ 0.05).在肺癌组中,ⅢA期、ⅢB期与ⅠA期比较、淋巴结转移N3组与N0组比较,CD+3、CD+3CD+4、CD+3CD+8、Th/Ts和CD+16CD+56表达差异均有统计学意义(均P＜ 0.05)；不同病理分型间各项指标表达差异均无统计学意义(均P＞ 0.05).结论动态监测肺癌患者外周血T淋巴细胞亚群与NK细胞可指导临床诊断和治疗,并有助于评估患者免疫功能状态.
목적 통과연구폐암환자외주혈T림파세포아군여NK세포적표체급동태변화,분석기여폐암발생、발전적관계급기림상의의.방법 운용류식세포술검측66례폐암환자(폐암조)、60례폐결핵환자(폐결핵조)화60명건강인(건강대조조)외주혈중CD+3、CD+3 CD+8、CD+3 CD+4、Th/Ts、CD+16CD+56적표체；폐암조환검측료화료전후제3、7화20천외주혈CD+3、CD+3 CD+8、CD+3CD+4、Th/Ts、CD+16CD+56적표체.결과 폐암조CD+3、CD+3CD+4、Th/Ts、CD+16CD+56표체명현강저[(54.23±10.37)％、(34.23±8.03)％、1.35±0.20、(25.18±4.34)％],여폐결핵조[(63.09±9.19)％、(39.46±12.74)％、1.51±0.41、(26.45±3.96)％]화건강대조조[(69.68±8.31)％、(42.31±13.29)％、1.89±0.48、(29.44±2.51)％]비교차이균유통계학의의(균P＜ 0.05)；CD+3CD+8표체삼조간차이균무통계학의의(균P＞ 0.05).재화료조중,화료완해조화료후제3천CD+3、CD+3CD+4、Th/Ts화CD+16CD+56표체교화료전균현저강저(균P＜0.01),이CD+3CD+8표체현저승고(P＜0.01)；제7천각항지표기본회복도화료전수평；제20천CD+3、CD+3CD+4、Th/Ts화CD+16CD+56표체교화료전균현저승고(균P＜0.05),이CD+3CD+8표체현저강저(P＜0.05).화료미완해조화료전후각항지표적표체차이균무통계학의의(균P＞ 0.05).재폐암조중,ⅢA기、ⅢB기여ⅠA기비교、림파결전이N3조여N0조비교,CD+3、CD+3CD+4、CD+3CD+8、Th/Ts화CD+16CD+56표체차이균유통계학의의(균P＜ 0.05)；불동병리분형간각항지표표체차이균무통계학의의(균P＞ 0.05).결론 동태감측폐암환자외주혈T림파세포아군여NK세포가지도림상진단화치료,병유조우평고환자면역공능상태.
Objective To analyse the relationship between T lymphocyte subsets and NK cells expression and dynamic changes in lung cancer patients 'peripheral blood and the occurrence and development of cancer,and investigate their clinical significances.Methods Flow cytometry was applied to detect 66 patients with lung cancer,60 patients with pulmonary tuberculosis and 60 healthy persons peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression.Lung cancer group peripheral blood CD+3,CD+3CD+8,CD+3CD+4,Th/Ts,CD+16CD+56 expression were also detected on 3rd,7th and 20th day before and after chemotherapy.Results Lung cancer group CD+3,CD+3CD+4,Th/Ts,CD+16CD+56 expression decreased significantly [(54.23±10.37)％,(34.23±8.03)％,1.35±0.20,(25.18±4.34)％] and had significant differences compared with pulmonary tuberculosis group [(63.09±9.19)％,(39.46±12.74)％,1.51±0.41,(26.45±3.96)％] and healthy group [(69.68±8.31)％,(42.31±13.29)％,1.89±0.48,(29.44±2.51)％](P ＜ 0.05),but CD+3CD+8 expression showed no significant difference(P ＞ 0.05).In chemotherapy group,comparing with before chemotherapy,remission group CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression decreased significantly (P ＜ 0.01)on 3rd day after chemotherapy,while CD+3CD+8expression increased significantly(P ＜ 0.01).On 7th day,each index recovered to the level of before chemotherapy basically.On 20th day,CD+3,CD+3CD+4,Th/Ts and CD+16CD+56 expression increased significantly(P ＜ 0.05)compared with before chemotherapy,while CD+3CD+8 expression significantly decreased(P ＜ 0.05).Chemotherapy unease group had no significant difference (P ＞ 0.05).Lung cancer of stage Ⅲ A and Ⅲ B compared with stage Ⅰ A,and lymph node metastasis in N3 group compared with N0 group,CD+3,CD+3CD+4,CD+3CD+8,Th/Ts and CD+16CD+56 expression had significant differences (P ＜ 0.05).Compared with their pathological types,each index had no significant difference(P ＞ 0.05).Conclusion Monitoring the peripheral blood T lymphocyte subsets and NK cells dynamic of lung cancer patients can guide the clinical diagnosis and treatment,and contribute to the assessment of immune function.