幽门螺杆菌相关性胃癌患者局部Th1/Th2细胞免疫应答变化

Changes of Local Th1/Th2 Cellular Immune Response in Gastric Cancer Associated with Helicobacter pylori Infection

背景:幽门螺杆菌(Hp)感染与胃癌发生相关,免疫应答可能是其主要致病机制之一。目的:探讨Hp相关性胃癌患者黏膜局部Th1/Th2细胞免疫应答变化。方法:选取2011年1～6月27例胃癌患者和28例对照者,采用14C-尿素呼气试验、Hp抗体检测Hp感染,免疫组化法检测胃黏膜局部干扰素(IFN)-γ和白细胞介素(IL)-4表达情况。结果:Hp总体感染率为61.8%。Hp阳性患者中,胃癌组IFN-γ表达明显低于对照组(P<0.05),IL-4表达明显高于对照组(P<0.05);Hp阴性患者中,胃癌组IFN-γ、IL-4表达与对照组均无明显差异(P>0.05)。Hp阳性胃癌患者IL-4表达明显高于Hp阴性胃癌患者(P<0.05),Hp阳性对照组IFN-γ表达明显高于Hp阴性对照组(P<0.05)。结论:Hp阳性对照者以Th1细胞介导的免疫应答为主,Hp阳性胃癌患者以Th2细胞为主。黏膜局部Th1/Th2细胞免疫应答变化可能与Hp感染相关疾病的进展,特别是胃癌的发生密切相关。

Background： Helicobacter pylori （Hp） infection is associated with the development of gastric cancer, and immune response may be one of the factors involved in its pathogenesis. Aims： To investigate the changes of mucosal local Th1/Th2 cellular immune response in gastric cancer associated with Hp infection. Methods： Twenty-seven gastric cancer patients and 28 controls from Jan. 2011 to Jun. 2011 were enrolled. 14C-urea breath test and Hp antibody test were used to detect Hp infection. Immunohistochemistry staining was used to determine the gastric mucosal local expressions of interferon-γ （IFN-γ） and interleukin-4 （IL-4）. Results： The overall Hp infection rate was 61. 8%. Compared with Hp-positive controls, IFN-γexpression in Hp-positive gastric cancer patients was significantly decreased （ P 〈 0.05 ）, while IL-4 expression was significantly increased （P 〈 0.05）. No significant difference in expressions of IFN-γ and IL-4 was found between Hp-negative gastric cancer patients and Hp-negative controls （ P 〉 0.05 ）. Expression of IL-4 in Hp-positive gastric cancer patients was significantly higher than that in Hp-negative gastric cancer patients （P 〈 0.05 ） ; expression of IFN-γin Hp-positive controls was significantly higher than that in Hp-negative controls （P 〈 0.05）. Conclusions： Th1 cells mediated immunity is predominant in Hp-positive controls, while Th2 ceils mediated immunity is predominant in Hp- positive gastric cancer patients. Mucosal local Th1/Th2 cellular immune response is correlated with the progression of Hp infection related diseases, especially the development of gastric cancer.