监测肾癌患者外周血CD4^+CD25^+调节性T细胞在术后免疫治疗中的作用

The role of CD4^+CD25^+ regulatory T cells in the patients of renal cell carcinoma

目的:探讨肾癌患者外周血CD4+CD25+T淋巴细胞的监测在术后辅助免疫治疗中的作用。方法:将24例肾癌患者随机分为两组:A组,根治性肾切除术后行IFN-α辅助免疫治疗;B组,单纯行根治性肾切除术;C组,10例健康对照。分别在术前、术后1周以及术后3个月免疫治疗结束时采集外周血样本,流式细胞仪检测CD4+、CD8+、CD4+CD25、CD4+CD25high T淋巴细胞亚群含量,并计算各部分比值。结果:A、B组术前CD4+CD25+、CD4+CD25high T淋巴细胞亚群总体上增加,并且其含量随肿瘤分期的进展而增加(P<0.05),但部分患者并不高于健康对照组。免疫治疗后,肾癌患者CD4+CD25+T淋巴细胞总体略有上升,但术前较高的患者中,约2/3下降。结论:利用流式细胞仪监测肾癌患者外周血CD4+CD25+T淋巴细胞亚群可反映机体抗肿瘤免疫状态,有助于预测免疫治疗的预后,为肾癌尤其是早期肾癌术后辅助免疫治疗的选择提供参考。

Objective ： To investigate the role of detecting peripheral blood CD4 ＋ CD25 ＋ regulatory T lymphocyte in adjuvant therapies after radical nephrectomy for renal cell carcinoma. Methods： All 24 renal cell carcinoma （RCC） patients were randomly divided into two groups： group A,patients received adjuvant therapies after radical ne- phrectomy, group B, only radical nephrectomy, 10 healthy persons as control. Peripheral blood was collected before surgery, one week and 3 months after surgery respectively. CD4 ＋ , CD8 ＋ , CD4 ＋ CD25 ＋ , CD4 ＋ CD25high T lympho- cyte subsets were detected by flow cytometry, and ratios of each part were calculated. Results： The percents of CD4 ＋ CD25 ＋ , CD4 ＋ CD25 high T lymphocyte subsets increased in group A and B, compared with group C, and there was a positive correlation between the trend of increasing and the stage of RCC （ P 〈 0.05 ）. But the percents of CD4 ＋ CD25 ＋ , CD4 ＋ CD25high T lymphocyte were not higher than that of healthy control. After 3 months of immune thera- py, the percent of CD4 ＋ CD25 ＋ T lymphocyte in RCC patients increased slightly. But the percent in about two third of patients who had a higher CD4 ＋ CD25 ＋ T lymphocyte percent before surgery, decreased after adjuvant immune thera- py. Conclusion： Detecting peripheral blood CD4 ＋ CD25 ＋ regulatory T lymphocyte subset by flow cytometry can re- flect the anti - tumor immune status of RCC patients. It can help predict the prognosis of immune therapy and provide reference for choice of adjuvant therapies after radical nephrectomy for RCC especially early stage RCC patients.