冷冻消融对晚期前列腺癌患者外周血CD4^+CD25^+调节T细胞影响的临床观察

Effect of Cryosurgery on Regulatory CD4+CD25+ T Lymphocytes in the Peripheral Blood of Patients with Advanced Prostate Carcinoma

目的:分析探讨氩氦冷冻治疗对前列腺癌患者外周血CD4+CD25+调节性T细胞(Treg)的影响及临床意义。方法:前列腺癌患者40例,分别于氩氦冷冻治疗术前、术后3个月、6个月采取外周血。放射免疫法检测外周血PSA,流式细胞仪检测外周血T淋巴细胞亚群(CD3+T、CD4+T、CD8+T、CD4+T,CD8+T、NK细胞、Treg细胞)变化情况。结果:前列腺癌患者冷冻后外周血PSA较冷冻前明显下降(P<0.01)。与治疗前比较。治疗后3个月、6个月CD3+T、CD4+T、CD4+T/CD8+T、NK细胞比例明显增高,CD8+T细胞比例降低(P<0.05),Treg细胞比例较治疗前降低(P<0.05)。冷冻后6月与冷冻后3月比较,Treg细胞无明显变化(P>0.05)。相关性分析结果表明:经氩氦冷冻治疗后Treg细胞比例变化与PSA下降呈正相关(r=0.76,P<0.01)。结论:前列腺癌氩氦冷冻治疗后外周血T淋巴细胞亚群分布异常得到一定改善,Treg细胞比例变化与肿瘤负荷大小有关。

Objective： To analyze the effect of Argon-Helium cryosurgery （AHCS） on the differentiation of regulatory CD4＋ CD25＋ T cell （Treg） and its implication in patients with prostate carcinoma. Methods： Peripheral venous blood samples were obtained from 40 patients with prostate cancer before AHCS and at 3 months and 6 months after AHCS. PSA in the peripheral blood was measured by radioimmunotherapy. The percentage of Treg cells and T lymphocyte subsets （CD3＋ T, CD4＋ T, CD8＋ T, CD4＋ T/CD8＋ T, and NK cells） in the peripheral blood was measured by flow cytometry. Results： After AHCS, PSA level in the peripheral blood was decreased significantly （P〈0.01）. After AHCS, the percentages of Treg cells were decreased （P〈 0.01）. At 3 months and 6 months after AHCS, the percentages of Treg cells were steady （P〉0.05）, the percentages of CD3＋ T, CD4＋ T, NK and CD4＋ T/CD8＋ T were significantly increased after AHCS （P〈0.01）, and the percentage of CD8＋ T cells was significantly decreased after AHCS （P〈0.01）. Correlation analysis showed that the decrease of PSA was positively correlated with the decrease of the percentage of Treg cells （r=0.76, P〈0.01）. Conclusion： After AHCS, the abnormal distribution of subsets of T-lymphocytes can be improved. The percentage of Treg cells is correlated with tumor load.