食管癌患者手术前后外周血T淋巴细胞亚群、NK细胞的测定及临床意义

摘要

目的 探讨检测食管癌患者手术前后外周血T淋巴细胞亚群、自然杀伤细胞(NK)水平变化,从免疫生物学角度探讨食管癌患者手术前后免疫功能的变化.方法 以26例健康体检者为对照组,96例食管癌患者为观察组,采用流式细胞仪检测对照组和食管癌患者手术前1天、术后第3天、术后第10天的外周血T淋巴细胞亚群CD3+T淋巴细胞(CD3+)、CD4+T淋巴细胞(CD4+)、CD8+T淋巴细胞(CD8+)、NK细胞(NK)的水平.结果 观察组术前、术后第3天及术后第10天外周血CD3+、CD4+、NK、CD4+/CD8+比值明显低于对照组(P＜0.05),CD8+明显高于对照组(P＜0.05).食管癌组术后第3天与术前各指标差异无统计学意义(P＞0.05).食管癌组术后第10天CD3+、NK较术前及术后第3天明显升高(P＜0.05),CD4+、CD4+/CD8+比值较术前明显升高(P＜0.05),术后第10天CD8+水平较术前、术后第3天明显降低(P＜0.05).食管癌组CD3+、CD8+与年龄、分化程度及浸润深度有关(P＜0.05),而与性别、KPS评分、肿瘤部位、病理形态、病变长度、有无淋巴结转移、病理类型均无相关性,差异均无统计学意义(P＞0.05).结论 食管癌患者免疫功能受到抑制,手术解除肿瘤负荷后患者免疫状态改善;T淋巴细胞亚群水平可能与食管肿瘤进展程度有关;T淋巴细胞亚群、NK在食管癌患者免疫监测中具有一定价值.%Objective To investigate the clinical significance of T lymphocyte subsets,NK cells level in the patients with esophageal carcinoma(EC) before and after operation.To explore the changes of the immune function of esophageal patients before and after surgery from the perspective of immune biology.Method Twenty-six cases of healthy control and 96 patients with EC were included in the study.The T lymphocyte subsets (CD3 + 、CD4 + 、CD8 +) and NK cells levels were reflected indirectly through the flow cytometry,the blood samples were collected at 1 day before operation,the third day and 10th day after surgery.Results The levels of CD3 + cells,CD4 + cells,NK cells and CD4 +/CD8 + ratio at the 1 day before operation (BO),third day postoperative (3DP) and 10th day postoperative group (10DP) were apparently lower than healthy control(HC) (P ＜ 0.05),and the level of CD8 + cells were significantly higher than HC (P ＜0.05).The index between BO and 3DP had no differences statistical significance (P ＞0.05).The expressions of CD3 + cells and NK cells in 10DP were significantly higher than those of in BO and 3DP(P ＜ 0.05),CD4 + cells and CD4 +/CD8 + ratio were significantly higher than BO (P ＜ 0.05),the expression of CD8 + cells was significantly lower than BO and 3DP(P ＜ 0.05).The levels of CD3 + cells and CD8 + cells were significant correlation with age,histological grade,depth of invasion (P ＜ 0.05),but had no correlation with gender,KPS grade,tumor site,pathology morphological,tumor length,lymph node metastasis and pathological type (P ＞ 0.05).Conclusion Their immune function were restrained,who with EC,and their immune status were improved after suigery.The T lymphocyte subsets might be associated with esophageal tumor progression.Detection T lymphocyte subsets and NK cells might have a certain value in monitoring the immune function of patients with esophageal cancer.