泌尿系肿瘤患者T淋巴细胞核仁组织区嗜银蛋白应用价值的研究

Clinical study on the rDNA transcription activity of peripheral T lymphocyte in patients with urinary tract tumors

目的探讨外周血T淋巴细胞核中的rDNA转录活性检测在泌尿系肿瘤患者中的应用价值。方法肾癌患者21例,TNM分期:T1N0M06例,T2N0M09例,T3N0M04例T4N2M12例;膀胱癌患者42例,TaN0M014例,T1N0M011例,T1N0M11例,T2N0M08例,T3N0M04例,T4N0M04例;常规体检正常者28例为对照组;血液透析治疗尿毒症患者23例作为阳性对照组。取外周血检测T淋巴细胞核仁银染面积与核面积的比值(AgNORs),比较组间差异和影响因素。结果泌尿系肿瘤和尿毒症患者外周血T淋巴细胞AgNORs含量显著低于正常对照组(8.55±1.11)%,P<0.01;肾癌患者T淋巴细胞AgNORs含量为(5.44±0.68)%,膀胱癌患者(5.42±0.68)%,显著低于尿毒症患者(6.29±0.97)%,P<0.01,且70%患者为低活性表达(<6.00%);术后2周内无显著性改变。外周血T淋巴细胞AgNORs含量与肿瘤分期分级、肾癌肿瘤体积、膀胱肿瘤细胞浸润能力及肿瘤复发次数等无显著相关。结论外周血T淋巴细胞AgNORs值可用于泌尿系肿瘤的免疫监测,有可能作为泌尿系肿瘤的初筛检查。

Objective To study the significance of rDNA transcription activity of peripheral blood T lymphocyte in patients with urinary tract tumors. Methods rDNA transcription activity of peripheral T lymphocyte was detected by a cell image analysis of Ag-NOR in 21 patients who were pathologically diagnosed with kidney cancer (including 6 cases of T_1N_0M_0,9 of T_2N_0M_0,4 of T_3N_0M_0 and 2 of T_4N_2M_1) and in 42 patients with bladder tumor (including 14 cases of TaN_0M_0,11 of T_1N_0M_0,1 of T_1N_0M_1,8 of T_2N_0M_0,4 of T_3N_0M_0 and 4 of T_4N_0M_0).Twenty-eight normal volunteers served as controls and 23 patients with uremia as positive controls.The peripheral blood was taken for detection of Ag-NORs in controls and in tumor patients before and after operation.The differences were compared among these groups. Results rDNA transcription activity of T cells was (8.55±1.11)%,(6.29±0.97)%,(5.44±0.68)% and (5.42± 0.68)% in controls and patients with uremia,renal and bladder tumors,respectively,showing a statistically significant difference among the normal uremia and tumor patients (P<0.01).The rDNA transcription activity of T cells in tumor patients was also statistically different from that of uremia patients (P<0.01).There were more than 70% of tumor patients with decreased rDNA transcription activity of T cells (< 6.00%). No statistically significant change of rDNA transcription activity of T cells was observed peri-operatively during the study (P>0.05).The parameters,such as TNM stages of renal and bladder tumor,the cell grades according to WHO criteria,tumor volume of the kidney,and invasion depth and recurrence frequencies of bladder tumors,had no significant correlation with rDNA transcription activity of T cells. Conclusions rDNA transcription activity of T cells may be used for monitoring the immune function in patients with kidney and bladder tumors,especially for primary screening of urinary tract tumors.