肺癌患者外周血调节性T细胞检测的临床意义

Clinical significance of regulatory T cell in peripheral blood in patients with lung cancer

目的:探讨肺癌患者外周血调节性T细胞(CD4+CD25+FoxP3+,Treg细胞)的变化及其与病理参数的相关性。方法:应用流式细胞仪检测56例肺癌患者和18名健康对照者(健康对照组)外周血单个核细胞(PBMC)中Treg细胞占CD4+T细胞的百分率,分析其与年龄、性别、肺癌分期、病理类型以及是否合并胸腔积液等的关系。结果:①肺癌患者外周血Treg细胞百分率高于健康对照组[(6.15±3.15)%比(3.65±2.48)%,P<0.01]。早期组(TNM分期:Ⅰa期～Ⅲa期)[(5.04±2.40)%]、晚期组(TNM分期:Ⅲb期～Ⅳ期)[(6.83±3.09)%]分别与健康对照组[(3.65±2.48)%]比较,Treg细胞百分率均明显升高(P<0.01)。②晚期肺癌患者中,非老年组(年龄≤60岁,12例)患者外周血Treg细胞较老年组(年龄>60岁,26例)明显升高[(8.79±3.49)%比(4.86±2.69)%],差异有统计学意义(P<0.01)。③根据病理类型分为非小细胞肺癌52例(18例鳞癌、34例腺癌),小细胞肺癌4例,非小细胞肺癌患者外周血中Treg细胞百分率较小细胞肺癌有增高趋势[(6.44±3.16)%比(3.44±1.97)%],但尚无统计学意义(P>0.05)。④肺癌患者外周血中Treg细胞百分率与性别、有无胸水无相关性(P>0.05)。⑤回归分析显示晚期肺癌患者外周血中Treg百分率与年龄呈负相关(P<0.05)。结论:肺癌患者处于免疫抑制状态,其外周血中Treg细胞百分率与肺癌分期、年龄有关。

Objective To investigate the correlation between changes of regulatory T cells in peripheral blood and clinicopathological parameters in patients with lung cancer.Methods The CD4＋CD25＋FoxP3＋ regulatory T cell （Treg） in peripheral blood of 56 lung cancer patients and 18 healthy controls were measured by flow cytometry,and the correlation between percentage of Treg in PBMC and clinical pathologic parameters of lung cancer such as cancer stage,age of patient,gender,pathologic type and complicated pleural effusion were analyzed.Results ① The percentage of Treg in lung cancer patients was significantly higher than that in healthy controls [（6.15± 3.15）% vs （3.65±2.48）%,P0.01].We compared seperately the percentage of Treg in early stage and late stage lung cancer with those in health controls,the results showed that the Treg percentage in both early and late stage lung cancer patients [（5.04±2.40）% and （6.83±3.09） %] were much higher than that in healthy controls [（3.65±2.48）%]（P0.01）.② In the late stage （TNMⅠa-Ⅲa）,the Treg percentage in non-elderly patients was higher than that in elderly patients [（8.79±3.49）% vs （4.86±2.69）%,P0.05].③ There was no significant difference of Treg percentage between various pathological types of lung cancer （P0.05）,although the Treg percentage of non-small cell lung cancer was somewhat higher than those of small cell lung cancer.④ There was no difference of Treg percentage between male and female,and with or without pleural effusion.⑤ Regression analysis showed that,in late stage lung cancer,Treg percentage had a negative correlation with age.Conclusions The patients with lung cancer are under immune suppressed status,and the Treg percentage has some correlation with tumor stage and age.