乳腺癌患者围术期活化细胞毒性T细胞百分率的动态变化及临床意义

摘要

目的 观察乳腺癌患者围术期活化细胞毒性T细胞(CTL)百分率的动态变化,探讨乳腺癌患者外周血活化CTL检测在乳腺癌患者围术期病情监测中的价值.方法 采用流式细胞术,以前向散射光和侧向散射光信号参数界定全血标本中的淋巴细胞,用CD3-FITC、CD8-APC、CD38-PE单克隆抗体分别检测淋巴细胞表面CD3、CD8、CD38抗原.所建方法分别对33例乳腺癌患者和20例健康志愿者的总T细胞(CD3+)和C T L(CD3+CD8+)中活化C T L(CD3+CD8+CD38+)的百分率进行检测,确定参考范围,并观察33例乳腺癌患者围术期总T细胞和C T L中CD3+CD8+CD38+细胞百分率的动态变化.结果 健康人群CD3+CD8+CD38+/CD3+和CD3+CD8+CD38+/CD3+CD8+的百分率分别为(13.46±4.08)%和(29.98±9.11)%.33例乳腺癌患者术前CD3+CD8+CD38+/CD3+[(10.44±6.61)%]和CD3+CD8+CD38+/CD3+CD8+[(22.34±10.68)%]均显著低于健康人群(P<0.05);术后第1天CD3+CD8+CD38+/CD3+[(9.64±6.16)%]明显低于术前(P<0.01);术后第7天CD3+CD8+CD38+/CD3+[(12.67±7.73)%]和CD3+CD8+CD38+/CD3+CD8+[(27.42±10.65)%]均明显高于术前(P<0.05);与健康对照差异均无统计学意义(P>0.05).结论 观察乳腺癌患者围术期CD3+CD8+CD38+细胞百分率的动态变化在乳腺癌围术期病情监测中有重要意义,有助于及时获知患者体内活化CTL恢复情况,利于患者选择合适的化疗时机.%Objective To observe the dynamic change of activated cytotoxic T lymphocyte (CTL) percentage during periopera-tive period in the patients with breast cancer and to explore the value of detecting the peripheral blood activated CTL in monitoring the perioperative condition of breast cancer patients .Methods The lymphocytes in whole blood were defined by forward scatter and side scatter (FSC/SSC) signal parameters by adopting flow cytometry (FCM ) ,the CD3 ,CD8 and CD38 antigens on lymphocyte surface were detected by CD3-FITC ,CD8-APC and CD38-PE monoclonal antibody ,respectively .The CD3+CD8+CD38+ percentage in 20 healthy people were detected with the established method to determine the reference ranges ,and the dynamic changes of CD3+CD8+ CD38+ cells percentage in total T cells and cytotoxic T cells of 33 patients with breast cancer during perioperative period were observed .Results The percentages of CD3+ CD8+ CD38+ /CD3+ and CD3+ CD8+ CD38+ /CD3+ CD8+ in healthy group were (13 .46 ± 4 .08)% and (29 .98 ± 9 .1)% ,respectively .Both the CD3+ CD8+ CD38+ /CD3+ [(10 .44 ± 6 .61)% ] and CD3+ CD8+CD38+ /CD3+CD8+ [(22 .34 ± 10 .68)% ] before operation in 33 patients with breast cancer were significantly lower than those in healthy group (P<0 .05);CD3+CD8+CD38+ /CD3+ [(9 .64 ± 6 .16)% ] on postoperative 1 d was significantly lower than that in preoperation(P<0 .01);CD3+CD8+CD38+ /CD3+ [(12 .67 ± 7 .73)% ] and CD3+ CD8+ CD38+ /CD3+ CD8+ [(27 .42 ± 10 .65)% ] on postoperative 7 d were significantly higher than those in preoperation (P<0 .05) ,the difference with the healthy control had no statistical significance(P>0 .05) .Conclusion Observing the dynamic change of CD3+CD8+CD38+ cells percentage has an impor-tant significance for monitoring the perioperative condition of the patients with breast cancer ,contributing to get the activated CTL recovery situation of the patients and to choose the correct chemotherapy occasion for the patients .