乳腺癌患者外周血T淋巴细胞和NK细胞水平分析

摘要

目的 探讨乳腺癌患者手术前后外周血淋巴细胞的变化及其与预后的关系.方法 采用流式细胞术检测59例无淋巴结转移乳腺癌患者手术前后外周血CD3+、CD4+、CD8+、自然杀伤细胞(NK)、CD19+细胞水平.随访1年,观察患者是否复发,并测定上述指标.结果 术后CD19+细胞水平较术前明显下降(P＜0.05),手术前后CD4+、CD8+、CD3+、NK细胞水平比较差异无统计学意义(P＞0.05).术后随访1年,复发10例,未复发49例.术后复发组的术前、术后外周血CD4+细胞水平明显低于未复发组(P＜0.05),CD8+、NK和CD19+细胞水平明显高于未复发组(P＜0.05),但两组CD3+细胞水平比较差异无统计学意义(P＞0.05).结论 监测乳腺癌患者手术前后外周血T淋巴细胞和NK细胞水平,能客观地反映患者机体的细胞免疫功能状态、宿主的免疫细胞数量与功能异常,对判断乳腺癌患者术后复发及预后有重要的参考价值.%Objective To investigate the changes of lymphocytes in peripheral blood of breast cancer patients before and after surgery, and their relationship with prognosis. Methods Flow cytometry was used to test levels of CD3 + , CD4 + , CD8 + , natural killer( NK ) cells and CD19 + in peripheral blood of 59 cases of breast cancer before and after operation. All the patients were followed up for one year for observing tumors relapse or not, and the indices above were detected. Results The level of postoperative CD19+ decreased significantly compared with preoperative one ( P < 0. 05 ). There was no significant difference in the levels of CD4 + , CD8 + , CD3 + and NK cells before and after surgery( P >0. 05 ). In the 1-year follow-up, there were 10 cases of tumor relapse and 49 cases without recurrence. The levels of CD4 + before and after surgery of postoperative recurrence group decreased significantly compared with those of non-recurrence group( P < 0. 05 ), and levels of CD8 + , NK cells and CD19 + of postoperative recurrence group increased significantly compared with those of non-recurrence group( P < 0. 05 ),but no significant difference was found in CD3 + cell level between two groups( P > 0. 05 ). Conclusion To monitor levels of T lymphocytes and NK cells in peripheral blood of breast cancer patients before and after surgery is able to indicate patients' cellular immune function, the hostis immune cell number and abnormal function, which is of great reference value to the diagnosis of tumor relapse and prognosis in breast cancer patients after surgery.