BCG膀胱灌注对局部免疫细胞功能的影响

The effect of intravesical BCG instillation on immunocompetent cells of the bladder wall

对２７例表浅膀胱癌术后ＢＣＧ膀胱灌注前后膀胱壁Ｔ＿３、Ｔ＿４、Ｔ＿８、ＩＬ－２Ｒ表达及尿液中肿瘤坏死因子（ＴＮＦ）含量进行了研究。结果表明，ＢＣＧ膀胱灌注后膀胱壁大量淋巴细胞浸润，Ｔ＿４／Ｔ＿８比值由灌注前０．６上升至１．９，２０例患者膀胱壁形成淋巴肉芽肿，粘膜下散在淋巴细胞表面广泛表达ＩＬ－２Ｒ，但肉芽肿淋巴细胞表面几乎不表达ＩＬ－２Ｒ。灌注后２４小时尿液中ＴＮＦ含量显著升高（Ｐ＜０．０１），实验结果提示：Ｔ＿４、巨噬细胞在ＢＣＧ抗肿瘤效应中起着非常重要的作用。

T_3,T_4,T_8 and the expression of IL-2R,the titer of urinary TNF were studied in 27 superficial bladder carcinoma patients both before and after the intravesical instillation of BCG,A large number of lymphocytes especially the T-helper cells infiltrating into the bladder wall and the ratio of T_4/T_8 increased from 0.6 to 1. 9 were noted after the instillation. In 20 cases, the lymphocytes formed granulomas in the bladder wall.Most of the dispersed lymphocytes expressed IL-2R but in the central part of the granuloma no IL-2R expression was detected.TNF titer in urine was significantly increased after BCG instillation(P<0.01).The result demonstrated that T4 and macrophage cell were the most important factors in BCG antitumor effect.