白介素-2治疗前后恶性胸腹水白细胞抗原DR、淋巴细胞微核含量及T细胞亚型改变的临床研究

The clinical study of the change of HLA-DR, PFLMNF and subtype of T cell in malignant ascites and hydrothorax before and post the treatment of IL-2

背景与目的:恶性胸腹水多为中晚期症状,控制恶性积液对于提高患者生活质量、延长患者生存期有着重要的意义。本研究探讨白介素-2治疗恶性积液前后积液中的人类白细胞抗原DR(HLA-DR)、淋巴细胞微核率(PFLMNF)以及T细胞亚型的改变,以预测治疗的效果及疾病的转归。方法:胸腹腔注射白介素-2(200万国际单位,每周2次,共2周)治疗良、恶性胸腔积液患者57例。采用液基细胞薄层制片术(TCT),采用免疫标记EnVison二步法观察T细胞免疫表型、HLA-DR及癌细胞免疫表型HLA-DR的表达。采用Giemsa-Wright染色观察PFLMNF。结果:A组胸腹水患者白介素-2治疗后,T细胞CD3、CD4、HLA-DR免疫表达信号增强,PFLMNF在治疗后患者中明显减低。结论:白介素-2可以上调人恶性胸腹水癌细胞HLA-DR抗原的表达,提示IL-2对癌性胸腹水的临床治疗具有一定的应用价值。

Background and purpose：Malignant effusion is a common complication in advanced cancer patients, effective therapy to control effusion increases the quality of life and overall survival in these patients.We evaluated the curative effects of IL-2 injection in patients with malignant effusion by intrapleural or intraabdominal injection.Methods：Fifty-seven patients with malignant（group A） or benign（group B） effusion were observed.Two million units of IL-2 were injected intrapleurally or intraabdominally, 2 times a week for 2 weeks.Results：The expression of CD3, CD4, HLA-DR in T cells were significantly increased in group A after IL-2 treatment, whereas the PFLMNF in group A dramatically decreased at the same time.Conclusion：IL-2 can increase HLA-DR expression, and it is a good choice for patients with malignant effusion.It is suitable for treating patients with malignant ascites and hydrothorax who cannot bear chemotherapy.