CD4+CD25+调节T细胞在平阳霉素胸膜固定术中的意义

摘要

目的 探讨外周血及胸水CD4+CD25+调节T细胞(Treg)在平阳霉素(PYM)胸膜固定术中的变化及临床意义.方法 23例肺癌并发恶性胸腔积液(MPE)患者给予PYM胸膜固定术,对固定术前及术后48h外周血及胸水采用流式细胞术观察Treg变化.结果 23例患者治疗4周后,有效14例,无效9例,有效率60.87%.有效组男11例,女3例,无效组男6例,女3例,两组给药前年龄、KPS评分、Treg在血及胸水中比较均无差异.术后患者血及胸水Treg较术前明显减低(血Treg:P=0.019;胸水Treg:P=0.039).有效组给药后血Treg降低显著(P=0.010),胸水Treg降低不显著(P=0.092);无效组血和胸水Treg降低均不明显.结论 PYM胸膜固定术可有效控制MPE,其疗效与PYM显著减少血Treg,促进炎症反应有关.%Objective To observe the changes of CD4 ＋ CD25 ＋ regulatory T cells(Treg) in patients with adbanced lung cancer treated by the intrapleural pingyangmycin administration unified chemotherapy. Methods 23 patients received PYM by intrapleural injection. Blood and pleural effusion samples were collected before pleuredesis and after 48 h were determined by flow cytometry for Treg. Resuits Four weeks after PY M administration, the total response rate of MPE control was 60. 87％, Ting in blood and pleural effusion samples after the administration are decreased evidently than those before the injection ( blood Treg: P = 0. 019; pleural effusion Treg: P =0. 039); In effective group,Treg in blood was decreased evidently after the injection( P = 0. 010 ) ,but Treg in pleural effusion had no diversity before and after treatment( P = 0. 092). Conclusion PYM can control MPE effectively by administing into the pleural cavity,The effect of PYM is related to the significantly reduced blood Treg, which can promote inflammatory reaction.