乳腺癌患者外周血树突状细胞亚群及其HLA-DR表达的变化

Changes of dendritic cells subsets and their HLA-DR expression in peripheral blood of breast cancer patients

目的:探讨乳腺癌患者外周血树突状细胞(DC)亚群和其HLA-DR表达变化及血浆中DC相关细胞因子水平的变化。方法:4色荧光流式细胞术分析57例乳腺癌术前、术后1周、术后6个月的患者及正常对照的外周血DC前体细胞pDC1/pDC2(CD11c+CD123-/CD11c-CD123+)比值及其HLA-DR的表达;酶联免疫吸附法检测血浆细胞因子白细胞介素-12p40(IL-12p40)、白细胞介素-10(IL-10)、γ-干扰素(IFN-γ)、白细胞介素-4(IL-4)水平。结果:57例乳腺癌患者中,2例Ⅲ期、4例Ⅳ期外周血pDC缺乏,其余患者Ⅰ、Ⅱ、Ⅲ、Ⅳ期外周血pDC1/pDC2比值分别为1.62±0.59、1.41±0.63、0.91±0.32、0.81±0.29,均显著低于对照组(1.94±0.44,P<0.05);Ⅰ、Ⅱ、Ⅲ期患者术后1周pDC1/pDC2比值为1.71±0.47、1.52±0.54、1.04±0.36,与术前比较均无显著差异(P>0.05),但显著低于对照组(P<0.05);术后6个月pDC1/pDC2比值分别为1.92±0.72、1.63±0.65、1.28±0.34,与术前比较,均有显著提高(P<0.05),但与对照组比较,仅Ⅰ期患者恢复正常(P>0.05),Ⅱ、Ⅲ期患者仍然显著降低(P<0.05)。乳腺癌患者pDC亚群HLA-DR表达以及血浆中IL-12p40、IL-10、IFN-γ、IL-4水平及IL-12p40/IL-10、IFN-γ/IL-4比值与对照组比较均无显著差异(P>0.05)。结论:Ⅰ-Ⅳ期乳腺癌患者外周血pDC1/pDC2比值降低,部分Ⅲ、Ⅳ期患者外周血pDC缺乏。pDC的HLA-DR表达及DC分泌相关细胞因子的能力没有同步变异。术后患者pDC亚群Ⅱ、Ⅲ期明显改善,Ⅰ期恢复正常。

AIM ： To explore the changes of the subsets and HLA - DR expression of dendritic cells and their concerning cytokine levels in peripheral blood of patients with breast cancer. METHODS ： The subsets of the precussors of dendritic cells （pDC） in the peripheral blood of 57 cases of patients with breast cancer before operation and a week or six months after operation and 20 cases of healthy controls were analyzed by four - color FCM. The levels of IL - 12p40, IL - 10, IFN -γ/and IL-4 in the plasmas were tested by ELISA. RESULTS： Among 57 cases of patients with breast cancer, 2 cases in m phase and 4 cases in Ivphase expressed deficiency of pDC, the ratios of pDCJpDC2 in the other cases in I , n, m, Iv phase were respectively 1.62 ±0. 59, 1.41 ±0. 63, 0. 91 ±0. 32, 0. 81 ±0. 29 before operation, which were markedly lower than those in controls （ 1.94 ± 0.44）. The ratios of pDCJpDC2 in the cases in I , II, m phase were 1.71 ± 0. 47, 1.52 ± 0. 54, 1.04 ± 0.36 a week after operation, which were the same as those in pre - operation, but markedly lower than those in controls. The ratios of pDC1/pDC2 in the cases in Ⅰ , Ⅱ,Ⅲ phase were 1.92±0. 72, 1.63 ±0.65, 1.28 ±0. 34 six months after operation, which were markedly higher than those in pre - operation, meanwhile, to compare with controls, those were still lower for patients in Ⅱ , Ⅲ phase except in Ⅰ phase. No difference between patients and controls in the expression of HLA -DR of pDCs and the levels of IL -12p40, IL- 10, IFN -γ/, IL -4 in plasmas and the ratios of IL - 12p40/IL - 10, IFN -γ/IL -4 was observed. CONCLUSION： The ratios of pDC1/pDC2 in peripheral blood of patients with breast cancer in Ⅰ- Ⅳphase are decreased. Parts of patients in Ⅲ, Ⅳ phase are deficiency of pDCs. HLA -DR expression of DCs and the ability of DCs which secret the concerning cytokines do not change as pDC subsets change, pDC subsets improve markedly in Ⅱ, Ⅲ phase patients and recover to the normal level in Ⅰ phase patients after operation.