乳腺癌患者术前、术后及化疗后外周血CD4+、CD8+和B细胞的变化及临床意义

摘要

目的 探讨乳腺癌患者术前、术后及化疗后外周血CD4+、CD8+和B细胞的变化及其与临床预后的关系.方法 选取2015年7月至2017年3月上海市闵行区中心医院普外科收治的乳腺癌患者79例.应用流式细胞术分析乳腺癌患者和良性乳腺肿瘤患者外周血CD4+、CD8+和B细胞水平的差异,以及乳腺癌患者术前、术后及化疗后T细胞亚群和B细胞水平及与乳腺癌患者不同TNM分期和分子分型之间的相关性.结果 在TNM不同分期CD4+细胞水平存在差异(均P<0.05),在良恶性肿瘤之间、化疗前后及不同年龄分层,CD8+细胞水平的差异均有统计学意义(均P<0.05),化疗后在不同的TNM分期(P=0.001)及分子分型存在差异(P=0.011);在良恶性肿瘤之间、化疗前后及不同年龄分层之间B细胞水平差异有统计学意义(均P<0.05),术后在不同的TNM分期之间及分子分型之间差异有统计学意义(P=0.026,P=0.022);CD8+、B细胞可能成为患者的预后因素,但CD8+与B细胞水平并非乳腺癌治疗后生存的独立预后因素.结论 外周血B细胞、CD4+和CD8+淋巴细胞水平对于乳腺癌的诊断和预后有一定价值,值得进行深入探讨并将其应用于临床.%Objective To investigate the changes of CD4+,CD8+and B cells in peripheral blood of breast cancer patients detected before and after surgery and following chemotherapy and the relationship with clinical prognosis.Methods Seventy-nine pa-tients with breast cancer who were admitted for treatment in the Department of General Surgery,Shanghai Minhang Central Hospital from July 2015 to March 2017 were enrolled for the study.T cell and B cell counts were detected by flow cytometry in the peripheral blood of breast cancer patients and benign breast cancer patients,and differences were analyzed between the patients of the 2 groups.Then,the relationship between T cell and B cell counts detected in the patients before and after surgery and following chemotherapy and those pa -tients with different TNM staging and molecular typing.Results There were statistical differences in CD4+cell counts and TNM stag-ing between the patients with malignant and benign tumors(P<0.05;P<0.05).There were also statistical differences in CD8+cell counts,when comparisons were made between the patients with malignant and benign tumors, before and after surgery and following chemotherapy,and between different age stages(P<0.05;P<0.05).After chemotherapy, there were statistical differences between different TNM stages(P=0.001)and molecular types(P =0.011).Statistical differences could also be seen in B cells between malignant and benign tumors,between before and after chemotherapy as well as between different age stages(P<0.05;P<0.05;P<0.05).After surgery,statistical differences could also be noted between different TNM stages(P =0.026)and molecular types(P =0.022).CD8+and B cells might be prognostic factors, however, the levels of CD8+and B cells were not necessarily independent predictors of survival after breast cancer treatment.Conclusion The levels of B cells, CD4+and CD8+in peripheral blood have a certain value for the diagnosis and prognosis of breast cancer patients,for this reason,it is worth further research and may promise fu-ture clinical application.