胃癌患者手术前后4种淋巴细胞表型的变化及其临床意义

Determination of four kinds of cell phenotypes of peripheral blood lymphocytes in patients with gastric cancer

目的 :探讨胃癌患者手术前后外周血淋巴细胞 ( PBL ) CD8、CD2 8、CD4 9b、CD4 9d等 4种表型的变化及其临床意义。方法 :应用 CD8、CD2 8、CD4 9b、CD4 9d单克隆抗体 ,采用流式细胞术 ,对 2 0例胃癌患者及同期非肿瘤患者 (对照组 ) PBL上述4种表型进行检测。 结果 :( 1)肿瘤组淋巴细胞 CD8的表达显著高于对照组 ( P<0 .0 1) ;而 CD2 8、CD8+ / CD2 8+ 、CD4 9d的表达则低于对照组 ( P<0 .0 1)。 ( 2 )进展期胃癌组 CD8+ / CD2 8+ 、CD4 9b的表达明显低于早期组 ( P<0 .0 5 ) ;淋巴结转移组CD2 8、CD8+ / CD2 8+ 、CD4 9d的表达低于无淋巴结转移组 ( P<0 .0 5 ) ;侵及浆膜层组 CD8的表达高于侵及黏膜、黏膜下层组 ,而 CD2 8的表达则低于侵及黏膜、黏膜下层组 ( P<0 .0 5 )。 ( 3 )根治及姑息切除肿瘤后 ,CD8的表达明显降低 ( P<0 .0 5 ) ,CD2 8、CD8+ / CD2 8+ 表达显著升高 ( P<0 .0 1) ;CD4 9b、CD4 9d的表达亦明显升高 ( P<0 .0 5 ,P<0 .0 1)。 结论 :胃癌患者淋巴细胞 CD8、CD2 8、CD4 9b、CD4 9d的表达与肿瘤的生物学行为密切相关 。

Objective: To investigate the expression of CD8,CD28,CD49b and CD49d in peripheral blood lymphocytes in patients with gastric cancer before and after surgery. Methods: Four kinds of cell phenotypes were measured by flow cytometry. Results: CD8 in cancer group was significantly higher than that in control group. CD28,CD8 +/CD28 + and CD49d were much lower than those in control group. CD8 +/CD28 + and CD49b in advanced stage group were significantly lower than those in early stage group. CD28,CD8 +/CD28 + and CD49d in lymph node metastasis group were much lower than those in lymph node negative group. CD8 and CD28 in cancer group involving serosa were respectively higher and lower than that involving mucosa and submucosa. After radical or palliative resection of the tumor, CD8 was decreased and CD28,CD8 +/CD28 +,CD49b,CD49d were increased significantly. Conclusion: Cell phenotypes of CD8,CD28,CD49b and CD49d of peripheral blood lymphocytes in patients with gastric cancer are closely related to biological characteristics of the tumor. Removal of the tumor may improve the cellular immunity of the patients.