胃癌手术前后外周血CD4+ CD25+调节性T细胞的变化及临床意义

摘要

目的:检测CD4+CD25+调节性T细胞(Treg)在胃癌手术前后外周血中的变化,探讨Treg在肿瘤免疫中的作用.方法:收集初治胃癌患者38例作为研究对象,同时收集20例健康人外周血作为正常对照组.检测手术前3d和手术后14d外周血中CD4+ CD25+ Treg比例及T细胞亚群,将各检测结果结合临床、病理指标进行统计学分析.结果:胃癌患者术前外周血中Treg比例显著高于术后比例以及对照组(P均＜0.01).胃癌患者术前外周血CD8+T细胞比例明显低于术后比例以及对照组(P均＜0.01).术前外周血CD8+T细胞比例与Treg比例呈负相关(P＜0.05).胃癌患者术前外周血中Treg比例在不同淋巴结转移情况和TNM分期之间差异具有统计学意义(P＜0.05),其与淋巴结转移和TNM分期呈正相关(P＜0.01).胃癌患者手术后Treg比例较术前下降,且下降程度与浸润深度、淋巴结转移、远处转移、TNM分期、分化程度、病理分型以及手术方式无相关性.结论:Treg可能通过抑制CD8+T细胞的增殖及功能,促进肿瘤细胞的生长和发展.Treg与肿瘤的侵袭、淋巴结转移有关,提示Treg在一定程度上可作为检测疾病进展的免疫学指标.%Objective: To delect the variation of CD4+CD25+regulatory T cell (Treg) in peripheral blood of gastric cancer, and explore the effects of Treg on tumor immunity. Methods: Peripheral blood were collected from 38 patients with gastric cancer on the 3th day before operation and the 14th day after operation, as control, peripheral blood from 20 healthy adults were also collected. Flowing cytometry were used to analyze CD4+CD25+ Treg, CD4+ T and CD8+ T cells. The results which combinded with clinical and pathological datum were statistically analysed. Results: In peripheral blood of patients with gastric cancer, the percentage of Tregs in pre-operation was significantly higher than these of post-operation and the control (P<0.01). The percentage of CD8+ T cells in pre-operative peripheral blood was significantly lower than these of post-operation and the control(P<0.01). The percentage of CD8+ T cells were negatively correlated with the percentage of Tregs in pre-operation peripheral blood(P<0.05).In pre-operative peripheral blood of patients with gastric cancer, the percentage of Tregs in different status of lymph node metastasis and TNM staging had significant difference (P<0,05), the percentage of Tregs in pre-operation was positively correlative with lymphatic metastasis and TNM stagmg(P<0.0l). In patients with gastric cancer, the decrease of CD4+CD25+ Tregs between post-operation and pre-operation had no correlationship with depth of invasion, lymphatic metastasis, TNM staging, degree of differentiation, histopathological type or operative approach of the tumor (P>0.05 ). Conclusion: Tregs promote tumor cell growth and development by inhibiting CD8+ T cell proliferation and function, which maybe one of the mechanism of im~ muno-inhibition in the patients with malignance. Tregs are related to the invasiveness and lymphatic metastasis of tumor, which indicate that Treg can be used to detect the disease progression as the immunological indicator.