流式细胞仪检测晚期肺癌患者外周血CD4^＋CD25^＋调节性T细胞的临床意义

The Clinical Significance of Detecting CD4 ^＋ CD25^＋ Regulatory T Cells in Peripheral Blood of Patients with Lung Cancer by Flow Cytometer

目的检测晚期肺癌患者外周血中CD4^＋T细胞、CD4^＋CD5^＋T细胞、CD4^＋FOXP3^＋T细胞亚群，分析其在不同类型肺癌中表达的特点，以探讨在晚期肺癌患者中检测CD4^＋CD25^＋FOXP3^＋调节性T淋巴细胞的临床意义。方法收集我院初次收治的晚期肺癌患者71例（其中鳞癌35例、腺癌33例、腺鳞癌3例）和同期健康查体正常者28例的外周血，采用流式细胞术检测外周血中相应的T细胞亚群。比较其在晚期肺癌患者与正常人之间以及不同类型肺癌中表达的差异及特征。结果①晚期肺癌患者CD4^＋CD25^＋T细胞、CD4^＋FOXP3^＋T细胞占CD4^＋T细胞的比例分别为24．3％±7．8％和7．9％±2．1％，与对照组（19．1％±3．4％和5．9％±3．5％）相比均明显升高，差异有显著性（P〈0．01）。CD4^＋T细胞占总淋巴细胞的比例以及CD4^＋FOXP3^＋T细胞占CD4^＋CD25^＋T细胞的比例与对照组相比，差异无显著性（P〉0．05）。②鳞癌中CD4^＋FOXP3^＋T细胞占CD4^＋T细胞的比例为6．8％±1．9％，低于腺癌（7．7％±1．1％），差异有显著性（P〈0．05）。结论①在肺癌患者外周血中，CD4^＋T细胞占总淋巴细胞的比例同正常人相比无变化，CD4^＋CD25^＋T细胞和CD4^＋FOXP3^＋T细胞占CD4^＋T细胞均明显增多。②在不同类型肺癌中，CD4^＋FOXP3^＋T细胞比例数是腺癌高于鳞癌。

Objective To explore the clinical significance of CD4 ^＋ CD25^＋ FOXP3 ^＋ regulatory T lymphocytes in patients with lung cancer. Three subsets of CD4 ^＋ T lymphocytes（ CD4 ^＋ T lymphocytes,CD4 ^＋ CD25 ^＋T lymphoeytes and CD4 ^＋ FOXP3 ^＋ T lymphocytes） were detected in this study, and their expression in different types of lung cancer was analyzed. Methods Seventy-one patients （ including 35 squamous carcinoma patients,33 adenocarcinoma patients and 3 adenosquamous carcinoma） receiving therapy for the first time in our hospital as well as 28 healthy people were enrolled in this study. The subsets of T lymphocytes were detected in peripheral blood by flow cytometer. Then the difference in expression of T lymphocytes among different types of lung cancer and the difference between the healthy people were analyzed. Results The percentage of CD4^＋ CD25 ^＋ T lymphoeytes and CD4 ^＋ FOXP3 ^＋ T lymphocytes in lung cancer patients were 24.3% ± 7. 8% and 7.9% ±2. 1% respectively,compared with the control group（ 19.1% ±3.4% and 5.9% ±3.5% ） ,there was significant difference （P 〈0. 01 ）. There was no significant difference in the percentage of CD4 ^＋ T lymphocytes and CD3^＋ FOXP5 ^＋ T lymphocytes between the patients and healthy people（ P 〉0.05 ）. The percentage of CD4^＋FOXP3 ^＋ T lymphocytes in the squamous carcinoma and adenocarcinoma were 6.8% ±1. 9% and 7.7% ± 1. 1% , compared with adenocarcinoma, the percentage of squamous carcinoma was lower （ P 〈 0.05 ）. Conclusion There were no significant difference （ P 〉 0.05 ） between the percentage of CD4 ^＋ T lymphocytes in the patients and the healthy people. The level of CD4 ^＋ CD25 ^＋T lymphocytes and CD4 v FOXP3 ^＋ T lymphocytes was increased in the lung cancer. The percentage of CD4 ^＋ FOXP3 ^＋ T lymphocytes in the adenocarcinoma was higher than that of aqtmmous carcinoma.