胃癌患者肿瘤浸润淋巴细胞CD28表达的检测及临床意义

Significance of measurement of the expression CD28 on tumor infiltrating lymphocytes in patients with stomach cancer

目的探讨胃癌患者肿瘤浸润淋巴细胞CD28的表达及其临床意义。方法用三色荧光标记流式细胞术检测48例胃癌患者肿瘤组织及切缘组织的肿瘤浸润淋巴细胞(TIL)。结果肿瘤组织TILCD8+CD28+细胞、CD8-CD28+细胞明显低于切缘组织(P<0.01),CD8+CD28-细胞则无统计学意义。肿瘤患者淋巴结转移后肿瘤组织TILCD8+CD28+细胞、CD8-CD28+细胞明显低于未转移组(分别为P<0.01,P<0.05),CD8+CD28-细胞差异无统计学意义。随着临床分期的进展,CD8+CD28+细胞、CD8-CD28+细胞逐渐减少,其中CD8-CD28+细胞临床Ⅰ期明显高于临床Ⅱ期、Ⅲ期、Ⅳ期(P<0.05);CD8+CD28+细胞临床Ⅰ期、Ⅱ期明显高于Ⅲ期、Ⅳ期(P<0.05);而CD8+CD28-细胞差异无统计学意义。结论检测胃癌患者的TIL中的CD8和CD28的表达,对了解患者的免疫状况、疾病进展和指导临床对患者进行免疫调节治疗方面有一定的价值。

Objective To investigate the significance of measurement of the expression CD28 on tumor infiltrating lymphocytes in patients with stomach cancer. Methods Subjects for this investigation include the tumor tissues and its nearby normal tissues from 48 patients with stomach cancer. The levels of the expression of CD28, CD8 on tumor infiltrating lymphocytes were analyzed by flow cytometry. Results First, the levels of the expression of CD8 ＋ CD28 ＋ and CD8 - CD28 ＋ on tumor infiltrating lymphocytes from the tumor tissues were remarkably lower than from its nearby normal tissues （ P 〈 0. 01 ）. There was no significant difference in the CDs CD~ expression on tumor infiltrating lymphocytes from the tumor tissues compared with its nearby normal tissues. Second,the levels of the expression of CD8 ^＋ CD28^- and CD8 - CD28 ＋ on tumor infiltrating lymphocytes from the tumor tissues in patients with lymph node metastasis were in evidence lower than in patients with the negative lymph node （P 〈 0. 01,P 〈 0. 05, respectively）. There was no significant difference in the CD8 ＋ CD28 - expression on tumor infiltrating lymphocytes from the tumor tissues in patients with lymph node metastasis compared with those in patients with the negative lymph node. Third, with advance of clinic classification, the amounts of CD8 ＋ CD28 ＋ cell and CD8 -CD28 ＋ cell on tumor infiltrating lymphocytes were decreasing. And the amounts of CD8 - CD28 ＋ cell in I stage group were higher than those in Ⅱ ,Ⅲ and Ⅳ stage group （ P 〈 0. 05 ） , but the amounts of CD8 - CD28 ＋ cell in Ⅰ and Ⅱ stage group were higher than those in m and IV stage group （ P 〈 0. 05 ）. However, there was no difference in the CD8 ＋ CD28 - expression. Condusion Detecting the expression of CD8 and CD28 in tumor infiltrating lymphocytes was of importance to acquire the immune conditions and the complaint advance of patients with stomach cancer and to conduct clinic to adjust the patient＇s immune function.