泌尿系移行细胞癌患者外周血CD4＋CD25highCD127low/-调节性T细胞的水平及意义

Level of CD4＋ CD25high CD127low/- regulatory T cells in transitional cell carcinoma patients and its clinical significance

目的探讨泌尿系移行细胞癌患者外周血CD4＋CD25highCD127low/-凋节性T细胞（Treg）的比例改变及其临床意义。方法采用流式细胞技术检测93例泌尿系移行细胞癌患者，38例泌尿系良性疾病患者及37名健康对照者外周血Treg占CD4＋T细胞的比例，并分析Treg水平与移行细胞癌临床病理分级及手术前后的变化情况。结果泌尿系移行细胞癌患者外周血Treg占CD4＋T细胞的比例较良性疾病组及健康对照组呈显著性增高（P〈0．01）；Treg水平与肿瘤复发，多发及淋巴结转移呈显著相关（P〈0．01），与肿瘤的病理分级也有相关性，但与肿瘤临床分期未见相关（P〉0．05）；手术切除肿瘤前后Treg水平也有差异（P〈0．05）。结论泌尿系移行细胞癌患者外周血中Treg水平增高，对泌尿系移行细胞癌具有肿瘤免疫抑制作用。手术切除肿瘤后患者外周血中Treg水平可以降低，但远期的免疫功能变化仍需进一步临床追踪。

Objective To evaluate the expressions of CD4 ＋ CD25highCD127low/- regulatory T cells （Treg） in peripheral Mood from patients with transitional cell carcinoma（TCC） in urinary system. Methods The proportion of Treg population in CD4＋ T cells from 93 patients with transitional cell carcinoma was evaluated. And flow eytometry was employed to analyze different clinieopathologie characteristics and detect the pre- and post-operative changes in 38 patients with benign urinary diseases and 37 healthy subjects. Results The proportion of Treg population in CD4＋ T cells in peripheral blood of patients with TCC significantly increased as compared with those with benign urinary diseases and healthy subjects. There was a strong correlation between the proportion of Treg and tumor recurrence, quantity, lymph node metastasis （P 〈 0. 01 ） as well as pathological stage ; no correlation was found between the proportion of Treg and clinical TNM stage （P 〉0. 05）. The proportion of Treg was also different at pre- and post-operation （P 〈0. 05）. Conclusion CD4 ＋ CD25highCD127low/- regulatory T ceils in peripheral blood from patients with TCC significantly increased as compared with that in patients with benign urinary diseases and in healthy subjects. It may be responsible for immune suppression in TCC patients. Tumor resection could decrease the proportion of Treg in peripheral blood, but the long-term change in immune function requires further investigations.