结直肠癌患者外周血Th1和Th2细胞的检测与临床意义

Detection of Th1 and Th2 cells in peripheral blood of the colorectal cancer patients

目的研究结直肠癌患者外周血CD4_+T细胞亚群Th1和Th2细胞的比例以及相关特异性转录因子与细胞因子的表达水平,并观察其与临床分期之间的关系。方法 43名结直肠癌患者(肠癌组)与30名健康体检志愿者(对照组)作为研究对象。结直肠癌患者外周血Th1和Th2细胞占CD4_+T细胞的比例运用流式细胞技术进行检测。采用实时荧光定量聚合酶链反应(quantitative Real-time PCR),检测外周血Th1/Th2细胞亚群特异性转录因子的相对基因表达量。血浆细胞因子的表达水平使用液相芯片技术方法定量检测。结果肠癌组外周血Th2细胞占CD4+T细胞的比例和Th2细胞特异性转录因子GATA-3的mRNA表达量均显著高于对照组(P<0.05)。肠癌组外周血Th1细胞特异性转录因子T-bet的mRNA表达量显著低于对照组(P<0.05),但Th1细胞占外周血CD4_+T细胞的比例与对照组差异无统计学意义(P>0.05)。血浆TNF-α、IL-1β和IL-15表达水平组间无显著差异(P>0.05)。结直肠癌患者血浆IFN-γ、IL-4和IL-6的表达水平与病程分期有关(P<0.05)。结论结直肠癌患者外周血中Th1细胞比例变化不明显而Th2细胞比例明显升高。结直肠癌患者血浆细胞因子的不平衡表达可作为机体免疫状态转换与病情判断的指标。

Objective To investigated the functional changes of Thl and Th2 cells in peripheral blood of colorectal cancer （CRC） patients. Methods Forty--three patients with CRC and 30 healthy donors were en- rolled. The proportions and related gene expression of specific transcription factor of Thl and Th2 cells in peripheral blood were determined by flow cytometry and quantitative real--time polymerase chain reaction （PCR）. The concentration of cytokines in plasma was measured by Bio--Plex cytokine multiplex assays. Results The frequency of Th2 cell and related gene expression of GATA--3 were significantly increased in CRC patients （ P〈0.05）. There were no significant differences between CRC and healthy controls regarding the proportions of Thl cells { P 〉0.05）, although the mRNA levels of T- bet was significantly down--regulated （ P〈0.05 ）. No difference among TNF-α, IL--1β and IL-15 were detected between the two groups （ P 〉0.05）. Plasma concentrations of IFN-γ, IL-4 and IL-6 were closely correlated with the stage of disease （ P d0.05）. Conclusion Imbalances in circulating Th2 in conjunction with considerable Thl population were found in patients with CRC, and it might be correlative with the state of immune suppression in CRC patients. The changed Thl/Th2 cytokine profile might represent an index for immunity switch in the development of CRC.