目的探讨Th17细胞功能活性及其相关调节性细胞因子在中晚期鼻咽癌患者免疫病理中的意义。方法28例中晚期鼻咽癌患者，应用流式细胞术检测外周血Thl7细胞数量比例，RT-PCR法检测ROR-γt mRNA转录水平，ELISA法检测血清白介素l0（IL-l0）和17（IL-17）及γ干扰素（IFN-γ）含量水平，并以l5例健康人作为对照，分析其组间差异及其意义。结果中晚期鼻咽癌患者外周血单个核细胞中Thl7细胞占CD4+T细胞的数量比例和ROR-γt mRNA的相对表达量均低于正常对照组（P＜0.05），血清IL-10水平高于健康对照组(P＜0.05)，IL-17和IFN-γ水平低于正常对照组(P＜0.05)，提示Th17细胞功能活性显示了一种与患者病情进展程度呈现负相关关系的趋势。结论 Thl7细胞数量及其功能活性降低，可能是中晚期鼻咽癌患者肿瘤微环境中免疫耐受现象突出、产生免疫逃逸的重要因素之一。一旦该结论得到确认，则有望成为新的干预治疗靶标。%Objective To investigate the implications of Th17 cells and its regulatory cytokines in patients with middle to late staged nasopharyngeal carcinoma (NPC) based on a clinical trial. Methods The ratio of Th17 cells in the peripheral blood mononuclear cells (PMBC) was detected among 28 patients with middle to late stage of NPC by the procedures of flow cytometry, and ROR-γt mRNA in PMBC was determined by RT-PCR technique. Furthermore, serum levels of IL-10, IL-7 and IFN-γ were assayed by the use of ELISA Meanwhile, 15 healthy persons were taken as the normal controls, all with these indicators detected at the same time. Results The ratio of Th17 cells to the total CD4+T cells and the transcriptional level of ROR-γt mRNA in PMBC were significantly lower in middle to late staged NPC patients than that of healthy controls, with the serum levels of IL-17 and IFN-γ being in the same tendency as compared with that of normal persons(P<0.05). However, the serum leve of IL-10 was obviously higher in these patients than that of healthy controls (P<0.05). This suggested that a negative relationship was present in the functional activity of Th17 cells with the severity of lesion for cases with middle to late staged NPC. Conclusion Decrease in the number ratio and functional activity of Th17 cells may be one of the important factors responsible for existing immune tolerance phenomenon that inducing immune escape in the tumor microenvironment among patients with middle to late staged NPC. Therefore, it may be taken as a new target for intervention and treatment once such a situation identified.
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