摘要
背景与目的:化疗是内科治疗结肠癌的主要方法之一,热化疗改善患者机体免疫状态的机制尚不清楚。本研究通过观察结肠癌患者化疗/热化疗前后CD4+CD25+调节性T(Treg)细胞及细胞毒T淋巴细胞功能的变化,探讨其临床意义。方法:入选结肠癌Ⅲ期术后患者60例,其中热化疗组30例,以单纯化疗组30例为对照组,收集患者治疗前后外周血,采用流式细胞术检测治疗前后外周血淋巴细胞中CD4+CD25+Treg细胞的表达,并检测患者CTL细胞杀伤功能。结果:⑴结肠癌患者单纯化疗组化疗前CD4+CD25+Treg细胞表达为19±9,化疗后为19±7,差异无统计学意义(F=0.026,P>0.05);热化疗组化疗前CD4+CD25+Treg细胞表达为19±5,化疗后为14±4,差异有统计学意义(F=2.198,P<0.05);⑵结肠癌患者单纯化疗组化疗前细胞毒T淋巴细胞(cytotoxicTlymphocytes,CTL)为10±3,化疗后为15±5,差异有统计学意义(F=187.801,P<0.05);热化疗组化疗前CTL为12±3,化疗后CTL为18±5,两组比较差异有统计学意义(F=236.097,P<0.05)。即化疗组治疗前后CD4+CD25+Treg细胞变化不明显,而化疗联合热疗组治疗后CD4+CD25+Treg细胞水平显著降低。两组结肠癌患者治疗后CTL细胞杀伤功能均明显增强,以热化疗组增强更明显。结论:热化疗可明显改善结肠癌患者的免疫抑制状态,增强患者的细胞毒T淋巴细胞的功能。化疗联合热疗可提高患者疗效和预后。
Background and purpose：Chemotherapy is one of the main methods for the treatment of colon cancer. The mechanism for thermochemotherapy to improve the immunity of patients is unclear. This study was designed to evaluate the changes and significance of circulating CD4^＋CD25^＋ regulatory T cells （Tregs） and cytotoxic T cell in patients with colon cancer treated by either chemotherapy or thermochemotherapy. Methods：Sixty patients with stage Ⅲ colon cancer were divided into two groups： 30 patients treated with thermochemotherapy and 30 with chemotherapy. CD4^＋CD25^＋ Tregs in peripheral blood before and after treatment were measured by flow cytometry. Meanwhile, the killing function of cytotoxic T cell was detected. Results：⑴There was no significant difference between CD4^＋CD25^＋ Treg level in colon cancer patients between two groups before treatment （19±7 vs 19±9, F=0.026, P〈0.05）. The Treg level in colon cancer patients before thermochemotherapy was at 19±5, higher than the level after thermochemotherapy （15±4, F=7.198, P〈0. 05）. ⑵CTL level in colon cancer patients before chemotherapy was 10±3, lower than the level after chemotherapy （15±5, F=189.807, P〈0.05）. CTL levels in colon cancer patients before thermochemotherapy was 12±3, lower than the level after chemotherapy （18±5, F=236.097, P〈0.05）. ⑶Treg levels were significantly reduced with thermochemotherapy whereas it did not change significantly with chemotherapy. The killing function of CTL after treatment was significantly enhanced in both groups although it was more significant in the thermochemotherapy group. Conclusion：Thermochemotherapy can significantly improve the status of immune suppression in colon cancer patients and enhance cytotoxic T lymphocytes function compared to chemotherapy.
出处
《中国癌症杂志》
CAS
CSCD
北大核心
2010年第8期626-629,共4页
China Oncology
基金
上海浦东新区科委课题(项目编号:PKJ2006-Y18)
