宫颈原位癌的T淋巴细胞亚群与中医证型的相关性研究

Relative Research of T Lymphocyte Subsets of Cervical Carcinoma and Traditional Chinese Differentiation Situ

目的:观察宫颈原位癌(Cervical Carcinoma in Situ,CIS)患者的中医证型与T淋巴细胞亚群的相关性。方法:选出64例女性,年龄、职业及经济状况类同:进行中医辨证分型,并检测外周血T淋巴细胞亚群。其中36例为澳门仁伯爵综合医院妇产科宫颈原位癌(CIS)患者,均作病理学确诊;28例非CIS女性为对照组。结果:36例宫颈原位癌(CIS)患者中,有32例辨证为脾虚证,占88.9%;并且以脾虚湿盛型最多,占34.0%。CIS患者更容易出现脾虚(P≤0.01);另一方面,脾虚患者亦较容易患上CIS(P≤0.01)。而81.3%CIS伴脾虚患者CD4+/CD8+比值异常。将CIS患者,按伴有或不伴有脾虚证分为两组,与正常对照组的外周血T淋巴细胞亚群比较,均发现CD3+、CD4+如许多晚期肿瘤患者一样显著下降,但CD8+并不升高,CD56反而明显升高。结论:宫颈原位癌患者大多伴有脾虚证(P≤0.01)的表现;大多数宫颈原位癌伴脾虚患者CD4+/CD8+比值异常(P≤0.01)。宫颈原位癌患者,不论伴或不伴有脾虚证,其CD3+、CD4+显著下降(P≤0.01),但CD8+并不升高,CD56则明显升高(P≤0.01)。研究结果证实宫颈原位癌和中医脾虚、现代医学的细胞免疫密切相关,并值得进一步探讨。

Objective： The relationship between the Cervical Carcinoma Situ,Traditional Chinese Differentiation and Cellular Immunity was studied in our research. We mainly analyzed the relationship between CIS, Spleen - asthenia and cellular immunity. Through this way, we tried to find out the mechanism of how CIS came out in the perspective of Traditional Chinese. Medicine： So that to investigate the relationship between the Traditional Chinese Differentiation and T lymphocyte subsets in patients of cervical carcinoma in situ. Methods： To proceed diagnosis and differentiation in TCM, and analyze the T lymphocyte subsets for total 64 female randomly,from May 2005 to April 2006. They had similar age,profession and economic situation. There were 36 cases of cervical carcinoma in situ at Obstetrics and Gynecology department of Centro Hospitalar Conde S. Januario in Macao. The diagnosis was confirmed by pathological result. 28 cases of health persons as control group. Results ： The patients of Spleen - asthenia were the most common in CIS （88.9%） ;Fluid Retention due to Spleen - asthenia（34.0% ） occupied the most. Abnormal ratio of CD4^＋/CD8^＋ was found in 81.3% patients of CIS with Spleen - asthenia. The CD3^＋, CD4^＋ decreased in patients of CIS, with or without Spleen - asthenia, but CD8^＋ was not high, CD56 elevated apparently. Conclusion ： Most of CIS patients had Spleen - asthenia （ P 〈 0.01 ）. Abnormal ratio of CD4^＋/CD8^＋ was found in many patients of CIS with Spleen - asthenia. In CIS cases ,with or without Spleen - asthenia, CD3^＋ , CD4^＋ decreased （ P 〈 0.01 ）, CD8^＋ the same, CD56 increased apparently （ P 〈 0.01 ）. Close relationship between cervical carcinoma in situ ,Spleen - asthenia and cellular immunity was confirmed in our study. It is worthy to have further study.