晚期肺癌患者化疗前后细胞免疫功能及T细胞分泌细胞因子的变化

摘要

Objective:To investigate the changes of cellular immune function and cytokines secreted by T lymphocyte after chemotherapy in patients with advanced lung cancer.Methods:Flow cytometry was performed to detect the proportions of CD4+T and CD8+T lymphocytes in peripheral blood mononuclear cells (PBMCs) as well as the level of cytokines secreted by CD4+T cells.Results:The proportion of CD4+T in PBMCs and the ratio of CD4+T/CD8+T were lower in patients with advanced lung cancer than those of the control group (P＜0.001) before chemotherapy,and increased after chemotherapy (P＜0.01 or P＜0.001).The proportion of CD8+T in PBMCs was higher in patients with advanced lung cancer than those of the health controls (P＜0.001) before chemotherapy,then it decreased after chemotherapy (P＜0.05).However,no obvious changes were found in the levels of cytokines secreted by Thl (such as IFN-γ,TNF-α and IL-2) or Th2 lymphocyte (IL-4,IL-6 and IL-10) in patients.Conclusions:Chemotherapy may increase the proportion of CD4+T lymphocytes in PBMCs in patients with advanced lung cancer,but shows little effect on the changes of cytokines secreted by Th 1 or Th2.%目的:探讨晚期肺癌患者化疗前后外周血中T细胞免疫功能及其分泌细胞因子水平的变化.方法:通过流式细胞仪检测57例晚期肺癌患者和22例健康体检者CD4+T淋巴细胞和CD8+T淋巴细胞在外周血单核细胞(PBMC)中所占比例以及外周血CD4+T细胞分泌细胞因子水平的变化.结果:晚期肺癌患者化疗前CD4+T细胞在PBMC中所占比例、CD4+T细胞与CD8+T细胞比值均低于健康人(P＜0.001),化疗后均较化疗前明显升高(P＜0.01或P＜0.001):化疗前CD8+T细胞在PBMC中所占比例高于健康人(P＜0.001),而于化疗后较化疗前明显下降(P＜0.05).治疗前后患者血清中CD4+T细胞分泌Th1细胞因子(IFN-y、TNF-α、IL-2)和Th2细胞因子(IL-4、IL-6、IL-10)水平均无明显变化(P＞0.05).结论:化疗能够增加肺癌患者外周血中CD4+T细胞所占比例,但对Th1、Th2所分泌的相关细胞因子水平影响不大.