非小细胞肺癌患者外周血Th1和Th2细胞因子的表达及其临床意义

Clinical significance of serum Th1 and Th2 cytokines in patients with non small cell lung cancer

目的探讨非小细胞肺癌（NSCLC）患者外周血Th1和Th2细胞因子的表达及其临床意义。方法采用流式细胞小球微阵列术（Cytometric Bead Array，CBA）检测99例NSCLC患者外周血血清中Thl细胞因子IFN—γ、TNF—α、IL-2和Th2细胞因子IL-4、IL-5、IL-10的含量，然后结合临床资料进行比较分析。结果各细胞因子与年龄、性别、组织学类型、疾病分期、吸烟状况均无相关性，但各细胞因子之间的表达密切相关。分层分析显示，IL-2、IL-4的表达与中晚期NSCLC的预后相关。排除年龄、性别、疾病分期、吸烟史的影响，高表达IL-2患者的死亡风险是低表达IL-2患者的0．46倍（CI：0123～0．92，P〈005）；与此相反，高表达IL-4患者的死亡风险是低表达IL-4患者的2.86倍（CI：120～682，P〈005）。结论Th细胞因子的检测可以反映机体的肿瘤免疫状态，间接提示患者的病情和预后。IL-2为中晚期NSCLC患者的预后良好独立因子，而IL-4则为不良预后因子。

Objective To investigate the clinical significance of serum levels of Thl and Th2 cytokines in patients with non small cell lung cancer. Methods Cytometric Bead Array was employed to detect serum levels of IFN-γ, TNF-α, IL-2, IL-4, IL-5 and IL-10 in 99 patients with non small cell lung cancer （NSCLC）. Results The serum levels of six cytokines were not correlated with age,gender,histological types,disease stage,smoking and treatment response of NSCLC patients （P 〉 0.05）. Split file analyses showed that levels of IL-2 and IL-4 were correlated with prognosis of patients with advanced NSCLC. Excluded age, gender, disease stage and smoking the mortality risk of patients with high IL-2 levels was 0.46 times as that of low IL-2 levels （CI：0.23-0.92, P〈 0.05）, while mortality risk with high IL-4 levels was 2.86 times that of low IL-4 levels（ CI：1.20-6.82, P〈 0.05 ）. Conclusion Detection of serum Th1 and Th2 cytokines may indicate the prognosis of patients with advanced NSCLC.