食管鳞癌患者手术前后外周血Th1、Th2类细胞因子的变化及其临床意义

Postoperative Th1 and Th2 type cytokine changes in patients with esophageal squamous cell carcinoma and their clinical significance

目的探讨食管鳞癌病人外周血Th1和Th2类细胞因子的表达状况以及手术对该表达状况的影响。方法采用ELISA法检测30例健康对照者和46例食管鳞癌病人术前、术后8 d、术后30 d的外周血单个核细胞(PBMC)培养液上清中Th1类细胞因子白介素2(IL-2)、γ干扰素(INF-γ)和Th2类细胞因子白介素4、6、10(IL-4、IL-6、IL-10)的表达情况。结果食管鳞癌病人外周血Th1类细胞因子IL-2、INF-γ的表达明显低于对照组(P<0.05),Th2类细胞因子IL-6的表达明显高于对照组(P<0.05),表达趋势与肿瘤的TNM分期相关;手术后上述表达情况逆转。结论食管鳞癌病人外周血Th2细胞功能增强,Th1细胞功能减弱;手术可逆转食管鳞癌病人Th1、Th2状态;Th1和Th2类细胞因子的动态检测可能为反映食管癌预后和转移或复发的指标。

Objective To study the expressions of Th1 and Th2 type cytokines in patients with esophageal squamous cell carcinoma and the influence of operation on such expressions. Method Enzyme-linked immunosorbent assay (ELISA) was used to detect Th1 (IL-2 and INF-γ) and Th2 type cytokines (IL-4, IL-6 and IL-10) in cultured peripheral blood mononuclear cells (PBMCs, for 48 h) from 30 healthy controls and 46 esophageal squamous cell carcinoma patients (collected before and 8 and 30 d after operation, respectively). Results Compared with the control group, the expressions of Th1 type cytokines, IL-2 and INF-γ, were significantly depressed in the PBMCs of the cancer patients (P<0.05), while expression of Th2 type cytokines, IL-6 was significantly enhanced (P<0.05), and IL-4 and IL-10 showed only slight enhancement. Such changes in the expressions of the cytokines showed a correlation with TNM (tumor-node-metastasis)stage of the tumors. After operation, the expressions of Th1 type cytokines increased and Th2 type cytokines decreased. Conclusions Th1 cells are suppressed in patients with esophageal squamous cell carcinoma, while the function of Th2 cells is enhanced. Operation may reverse such changes, and dynamic detection of Th1 and Th2 type cytokines may indicate the prognosis, therapeutic effect and risks of relapse and metastasis.