甲状腺癌患者手术前后 CD8＋CD28-调节性T细胞的变化与临床意义

摘要

目的：探讨甲状腺癌患者手术前后CD8＋CD28-调节性T细胞的变化与临床意义。方法收集接受手术治疗的双侧甲状腺癌患者30例作为观察组（A），分别收集良性甲状腺瘤患者（B）及健康体检者（C）各30例作为对照组；采用流式细胞术检测三组外周血CD8＋CD28-调节T细胞百分含量及其胞内细胞因子转化生长因子β1（TGF-β1）及白介素10（IL-10）的平均荧光强度；比较术后4周甲状腺癌患者上述指标的变化。结果与C组比较，A及B组CD8＋CD28- T细胞及TGF-β1均升高，但B与C组无统计学差异，而A组两者均显著高于C组（P＜0．05）；与C组比较，A及B组IL-10均显著升高，且三组间两两比较均有统计学差异（P＜0．05）；手术后4周复查显示A组患者CD8＋CD28-T细胞、TGF-β1及IL-10三者与手术前比较均有显著性差异（P＜0．05），其中以CD8＋CD28-T细胞的回落最为明显，TGF-β1次之。结论 CD8＋CD28-T细胞、TGF-β1及IL-10表达增加是甲状腺癌患者的一个重要免疫学特征；TGF-β1是相对特异的一个细胞因子，在评价术后疗效较IL-10敏感。%Objective To explore the changes and significance of CD8+CD28- regulatory T lymphocytes for patients with thyroid carcinoma undergoing radical mastectomy. Methods Thirty cases with bilateral thyroid carcinoma treated with surgical treatment were selected as the observation group (A group), and 30 cases with benign thyroid tumor and healthy volunteers were served as controls (A group and C group). Using flow cytometry detected three sets of peripheral blood CD8+CD28-regulating T cell growth factors and their intracellular cytokines 1 (TGF-beta 1) and the frequency of interleukin 10 (IL-10). The indexes obove were compared between. Results Compared with group C,A and B group of CD8 +CD28 -T cells and TGF-beta 1 were higher,but no statistical difference was found between group B and C,and the group A were significantly higher than that of group C (P<0.05). Compared with group C,IL-10 in A and B group were significantly increased, and the comparison between two groups have statistical difference (P<0.05). In 4 weeks after surgery in group A, CD8+CD28- T cells,TGF-beta 1 and IL-10 level were reduced than that before the operation (P<0.05), especialy CD8+CD28-T cells and TGF-beta. Conclusion CD8+CD28-T cells, TGF-beta 1 and IL-10 expression increases are important immunological factors in patients with thyroid cancer. TGF-beta 1 is relatively specific cytokines and is more sensitine than IL-10 in evaluating the operative efficacy.