鼻咽癌患者外周血CD4^+CD25^(high)Treg细胞在肿瘤进展中的变化

Variation of CD4^+CD25^(high)Treg in peripheral blood of patients with nasopharyngeal carcinoma

目的观察分析鼻咽癌(nasopharyngeal carcinoma,NPC)患者外周血CD4+CD25high调节性T细胞(regulatory T cells,Treg)在肿瘤进展中的变化与意义。方法用流式细胞仪检测52例NPC患者、8例鼻咽黏膜慢性炎(nasopharyngitis,NPi)患者、7例头颈部其他癌(HNOC)患者和15例体检健康者外周血中CD3+、CD4+、CD8+T细胞和CD4+CD25highTreg比例。结果 NPC、NPi和HNOC组外周血CD4+CD25highTreg亚群均明显高于健康对照组(6.86%、6.50%、4.91%vs4.17%;U=113.50,P=0.000;Z=-2.519,P=0.011;Z=-2.328,P=0.017),尤以NPC和NPi水平为高;CD4+CD25highTreg在NPC出现淋巴结转移时明显增高(N1,12.69%vsN0,6.11%;Z=-2.904,P=0.003),病情继续进展又迅速回落(2期13.95%vs3期5.49%)。结论外周血CD4+CD25highTreg亚群升高始于NPi阶段,NPC初期无明显变化,一旦出现淋巴结转移,其明显升高达峰值,随NPC进一步进展又回落至NPi时的水平。

Objective The changes of CD4＋CD25high regulatory T cells（Treg） in peripheral blood of the patients with nasopharyngeal carcinoma（NPC） were observed to explore the effect of peripheral Treg on NPC progression.Methods The ratio of CD3＋,CD4＋,CD8＋ T cells and CD4＋CD25high Treg in peripheral blood samples were examined with flow cytometry.The blood samples were collected from the patients of 52 NPC,8 nasopharyngitis（NPi）,7 other head and neck malignant tumors and 15 healthy individuals.Results The levels of Treg subset in peripheral blood of the groups of NPC,NPi and other head and neck malignant tumors（6.86%,6.50%,4.91%）were significantly higher than those of healthy control group（4.17%）,（U=113.50,P=0.000;Z=-2.519,P= 0.011;Z=-2.328,P= 0.017）.The Treg levels in NPC and NPi groups were much higher than that in other head and neck malignant tumor group.The peripheral CD4＋CD25highTreg rose sharply at the time of tumor cells starting to metastasize to lymph node（N1：12.69% vs N0：6.11%;Z=-2.904,P=0.003）,then quickly dropped down to the level of NPi group with further progression of tumor（at stage 3：5.49% and stage 4：6.59%）.Conclusions The level of Treg subset in peripheral blood increases in the patients with NPi.No significant change of Treg level are found in the early stage of NPC,but it rises and reaches the peak once lymph node metastasis.Treg level drops down to the level of NPi with further progression of NPC.