肺癌患者外周血细胞亚群及其与临床关系分析

Analysis of peripheral blood cell subsets in patients with lung cancer and its relationship with clinic

目的分析肺癌患者外周血T细胞亚群及NK细胞活性的表达,研究其与肺癌患者临床分期及化疗的关系。方法分析2009年6月至2010年7月苏州大学附属第一医院收治的89例肺癌患者及30例健康体检者外周血中流式细胞仪（flowcytometry,FCM）检测的T细胞亚群及NK细胞活性及血中CEA含量。结果Ⅰ~Ⅱ期、不同病理分化级别及CEA正常范围内的肺癌患者外周血各细胞亚群分布与健康对照组无统计学差异;Ⅲ~Ⅲ期及CEA升高肺癌患者CD4＋、CD4＋/CD8＋、CD2＋8细胞比值下降（P〈0.05）,CD8＋、CD4＋、CD2＋5细胞比值升高（P〈0.05）,NK细胞比例较健康对照组无统计学差异。化疗2周后患者外周血CD3＋、CD4＋、CD4＋/CD8＋、CD2＋8比值降低（P〈0.01）,CD8＋、CD4＋、CD2＋5细胞比值升高（P〈0.01）,NK细胞比例升高。结论肺癌患者免疫功能存在一定抑制,Ⅲ~Ⅳ期及CEA升高的患者免疫抑制更明显,化疗后患者各细胞亚群分布较前并未得到改善,甚至恶化。

Objective To assay the distribution of T cell subsets,NK cells in peripheral blood of lung cancer patients and investigate the relationshiop between them and the clinical stage and chemotheropy of lung cancer patients.Methods There were 89 lung cancer in-patients and 30 healthy examined persons from June 2009 to July 2010,and the proportions of CD＋3,CD＋4,CD＋4/CD＋8 T cells and CD＋16 CD＋56,CD＋4 CD＋25,CD＋8 CD＋28 cells in peripheral blood detected by flow cytometry（FCM） and the level of CEA of them were analyzed retrospectively.Results There were no significant difference of the distribution of cell subsets in periheral blood between lung cancer patients who were in phase of Ⅰ-Ⅱ stage and had different pathological differentiation of cancer and normal level of CEA and healthy controls.For lung cancer patients who were in the phase of Ⅲ~Ⅳ stage and had high level of CEA,the CD＋4 and CD＋8 CD＋28 value and the ratio of CD＋4/CD＋8 decreased（P0.05）,CD＋8 and CD＋4 CD＋25 value increased（P0.05） compared to healthy controls and the activity of NK cells showed no significant difference.Two weeks after patients suffered from chemotheropy,the CD＋4 and CD＋8 CD＋28 value and the ratio of CD＋4/CD＋8 decreased（P0.01）,CD＋8 and CD＋4CD＋25value increased（P0.01） and the ratio of NK cells increased（P0.01）.Conclusions The immune function of Lung cancer patiens has some degree of suppression especially when they are in the phase of Ⅲ~Ⅳ stage and have high level of CEA.There is no improvements of the distribution of cell subsets after chemotherophy,and even gets worse.