肿瘤患者化疗前后外周血NK/T及Treg细胞比例分析

Analysis of NK/T and Treg cell in peripheral blood of patients with different malignancies during the chemotherapy

目的探讨肿瘤患者化疗前后,外周血免疫激活细胞及免疫抑制细胞比例变化。方法本研究通过分析38例健康人外周血NK/T细胞及Treg细胞流式分析结果,并跟踪本中心140例常见肿瘤患者(结直肠癌31例、胃癌21例、乳腺癌27例、肺癌61例),发病前后、化疗疗程中外周血中的NK/T细胞及Treg细胞比例。结果恶性肿瘤患者外周血中Treg细胞比例显著高于健康对照组分别为(6.95%±8.96%)、(4.25%±2.59%),P<0.05,NK细胞比例也显著高于健康人分别为(18.56%±9.19%)、(12.37%±6.24%),P<0.01。因统计病例数目有限,对69例肿瘤患者化疗的后续随访中发现,随着化疗进程,NK细胞以及Treg的比例变化无统计学意义,但在结直肠癌及胃癌中,Treg细胞比例可见先降低后升高的趋势。结论肿瘤患者外周血Treg细胞比例高于健康人,在化疗过程中NK细胞比例以及Treg细胞比例均高于化疗前水平。随着本研究的继续深入,可能进一步证实Treg细胞在肿瘤中富集,形成免疫抑制微环境,是通过抑制CD4+、CD8+T淋巴细胞及NK细胞的肿瘤杀伤效应,介导肿瘤免疫逃逸的可能。

Objective To discuss the imbalance of the cancer patients＇ cell immune system by investigating the dynamic change of activated and suppressed immune cell standards before and after chemotherapy. Methods The proportions of NK/T and CD4^± CD25^high CD127^±Treg ceils in the peripheral blood of patients with 140 different malignancies （31 colorectal,21 gastric, 27 breast and 61 lung cancers） and 38 healthy donors were determined by flow cytometry. Then,we compared the variation of Treg and NK cells in peripheral blood samples that taken from the patients,followed after the 1 st, 2nd, 3rd, 4th and 5th chemotherapy cycles. Results The mean percentage of Treg cells from cancer patients＇ peripheral blood was significant higher than that of healthy donors （6.95% ± 8.96% ）, （4.25 % ± 2.59% ）, P 〈 0.05. And the mean percentage of NK cells was also significant higher than that of the healthy donors （ 18.56% -± 9.19%）,（ 12. 37% ± 6. 24%）, P 〈 0. 01. As the case number limited, during the following up chemotherapy cycles of 69 cancer patients, there were no significant variations of NK cells, CD4 ~ T cells, CD8 ~ T cells, and Treg cells in these procedures. But some tendencies would be still noticed that CD4^＋ helper T cells and CD4^＋ CD^25high CD127^＋ regulatory T cells decreased at first and then increased as chemotherapy progressed. Conclusions The comparison between cancer patients and healthy donors has shown that the average percentage of Treg cells in the peripheral blood is higher in the patients. And the portions of Treg cells and NK cells are a little bit higher during the chemotherapy than pretreatment.