CAJ | 학술논문

目的：观察直肠癌患者新辅助治疗后外周血中免疫细胞比例的变化，并探讨外周血调节性T（Treg）细胞与肿瘤缓解的关系。方法前瞻性入组2013年1—12月间山西省肿瘤医院结直肠外科接受新辅助治疗的直肠癌患者，并按照新辅助治疗后T或N分期是否降期，分为降期组和未降期组。分别检测患者新辅助治疗前后外周血中CD4＋CD25highCD127low Treg细胞、CD4＋T细胞、CD8＋T细胞、NK细胞和B细胞占淋巴细胞总数的比例，观察免疫细胞比例的变化。结果共纳入108例患者，其中降期组76例，未降期组32例。两组患者治疗前各免疫细胞比例的差异均无统计学意义（均P＞0．05）。降期组新辅助治疗后CD4＋／CD8＋T细胞比值、Treg细胞和B细胞均显著下降（均P＜0．05），但NK细胞的变化无统计学意义（P＞0．05）；未降期组新辅助治疗后CD4＋／CD8＋T细胞比值和B细胞均显著下降（均P＜0．05），但Treg细胞和NK细胞的变化无统计学意义（均P＞0．05）。新辅助治疗后，降期组Treg细胞比例较未降期组明显减少[（4．4±1．7）％比（6．2±1．9）％，P＝0．001]。结论直肠癌新辅助治疗后肿瘤降期患者外周血Treg细胞比例明显降低可作为判断肿瘤缓解的参考指标。
목적：관찰직장암환자신보조치료후외주혈중면역세포비례적변화，병탐토외주혈조절성T（Treg）세포여종류완해적관계。방법전첨성입조2013년1—12월간산서성종류의원결직장외과접수신보조치료적직장암환자，병안조신보조치료후T혹N분기시부강기，분위강기조화미강기조。분별검측환자신보조치료전후외주혈중CD4＋CD25highCD127low Treg세포、CD4＋T세포、CD8＋T세포、NK세포화B세포점림파세포총수적비례，관찰면역세포비례적변화。결과공납입108례환자，기중강기조76례，미강기조32례。량조환자치료전각면역세포비례적차이균무통계학의의（균P＞0．05）。강기조신보조치료후CD4＋／CD8＋T세포비치、Treg세포화B세포균현저하강（균P＜0．05），단NK세포적변화무통계학의의（P＞0．05）；미강기조신보조치료후CD4＋／CD8＋T세포비치화B세포균현저하강（균P＜0．05），단Treg세포화NK세포적변화무통계학의의（균P＞0．05）。신보조치료후，강기조Treg세포비례교미강기조명현감소[（4．4±1．7）％비（6．2±1．9）％，P＝0．001]。결론직장암신보조치료후종류강기환자외주혈Treg세포비례명현강저가작위판단종류완해적삼고지표。
Objective To observe the proportion change of immune cells in the peripheral blood of patients with rectal cancer after neoadjuvant therapy and to explore the relationship between tumor regression and CD4 +CD25HighCD127low regularly T cells (Treg cells). Methods Patients with rectal cancer who underwent the neoadjuvant therapy before surgery at the Shanxi Cancer Hospital Colorectal Surgery Department from January to December 2013 were prospectively enrolled. These patients were divided into down-staging group and non-down-staging group according to the change of staging in accordance with TNM classification for rectal cancer after neoadjuvant therapy. Flow cytometry was used to analyze the proportions of Treg cells, CD4+T cells, CD8+T cells, NK cells, B cells, and CD4+/CD8+ratio in the peripheral blood from these patients before and after neoadjuvant therapy. Results A total of 108 patients were enrolled, including 76 cases in the down staging group and 32 cases in the non-down-staging group. Differences of immune cells proportions between two groups before neoadjuvant therapy were not statistically significant(all P>0.05). In the down-staging group, the proportions of Treg cells, B cells and CD4+/CD8+ ratio were decreased while the proportion of NK cells did not change obviously after the neoadjuvant therapy. Interestingly, in the non-down-staging group, the proportions of B cells and CD4+/CD8+ ratio were decreased while the proportions of Treg cells and NK cells did not change obviously after the neoadjuvant therapy. In addition, after neoadjunvat therapy, the proportion of Treg cells in down-staging group was significantly lower than that in non-down-staging group [(4.4±1.7)% vs. (6.2±1.9)%, P=0.001]. Conclusion For patients in the down-staging group after neoadjuvant therapy, the proportion of Treg cells in peripheral blood decreases, suggesting that Treg cells may be a valuable biomarker for assessing tumor regression.