Th17细胞和IL-21在非小细胞肺癌患者外周血的表达及临床意义

Detection and clinical significance of Th17 cells and IL-21 in peripheral blood of patients with non-small cell lung cancer

目的探讨Th17细胞及白介素21(IL-21)在非小细胞肺癌(NSCLC)发生发展中的作用。方法采用流式细胞术(FCM)检测60例NSCLC患者(NSCLC组)化疗前外周血Th17细胞占CD3+T细胞的比例,同时采用酶联免疫吸附试验(ELISA)检测血清IL-21的浓度。依据美国联合癌症分类委员会(AJCC)和国际抗癌联盟(UICC)2002年制定的TNM分期标准,将入选病例分组:其中Ⅰ期6例,Ⅱ期17例,Ⅲ期(ⅢA+ⅢB)25例,Ⅳ期12例,分析Th17细胞及IL-21与NSCLC患者临床病理因素的关系,并与20例健康体检者(对照组)对比分析。对照组年龄、性别构成与NSCLC组相近。结果 NSCLC组Th17细胞占CD3+T细胞的比例与对照组之间差异无统计学意义(P>0.05);NSCLC组IL-21浓度高于对照组[(79.44±16.46)pg/ml vs(70.92±12.98)pg/ml,P<0.05)。Th17细胞和IL-21的水平与NSCLC患者年龄、性别无关,与其病理类型有关,鳞癌患者Th17细胞、IL-21的表达水平均高于腺癌患者(P<0.05)。NSCLC患者外周血Th17细胞、IL-21的表达水平随着临床分期的进展而逐渐降低,组间比较差异有统计学意义(P<0.05)。Th17细胞与IL-21的变化呈正相关(r=0.532,P<0.05)。结论 Th17细胞和IL-21在NSCLC患者外周血的变化可能与其恶性程度及TNM分期有关。

Objective To investigate the roles of Th17 cells and interleukin-21（IL-21） in the occurrence and development of non-small cell lung cancer（NSCLC）.Methods Flow cytometry（FCM） was used to detect and analyze the proportion of Th17 cells in CD3＋T cell,and enzyme-linked immunosorbent assay（ELISA） was used to detect the concentration of IL-21 in peripheral blood of 60 cases of NSCLC（NSCLC group）.According to TNM staging criteria established by AJCC and UICC in 2002,the cases were grouped,including 6 cases of stage Ⅰ,17 cases of stage Ⅱ,25 cases of stage Ⅲ（ⅢA＋ⅢB）,12 cases of stage Ⅳ.Relationship between expression of Th17 cells and IL-21 and clinicopathological factors was analyzed.Twenty healthy individuals were chosen as control group.The age and gender were similar between controls and NSCLC patients.Results The Th17 cells proportion in CD3＋T cells was not significantly different between NSCLC group and control group（P0.05）.The concentration of IL-21 in peripheral blood of patients with NSCLC was significantly higher than that in controls[（79.44±16.46）pg/ml vs（70.92±12.98）pg/ml,P0.05].The expression levels of Th17 cells and IL-21 were correlated with the pathological type,but not with age,gender.The expression levels of Th17 cells and IL-21 in patients with squamous cell carcinoma were significantly higher than those in adenocarcinoma patients（P0.05）.With the progress of clinical stage,the levels of Th17 cells and IL-21 in peripheral blood of patients with NSCLC gradually decreased,and there was significant difference（P0.05）.Expression of Th17 cells was positively correlated with the level of IL-21（r=0.532,P0.05）.Conclusion The expression of Th17 cells and IL-21 in peripheral blood of NSCLC patients could be related to the tumor malignant degree and TNM stage.