结肠癌患者化疗/热化疗前后CD4^+CD25^+T细胞和CTL细胞的变化及临床意义

The changes and clinical significance of CD4^+CD25^+ regulatory T cells and cytotoxic T cell in patients with colon cancer treated by chemotherapy or thermochemotherapy

目的探讨结肠癌患者化疗/热化疗前后CD4+CD25+T细胞和CTL的变化及临床意义。方法选取68例结肠癌患者,分为化疗组34例和热化疗组34例,患者治疗前后采用流式细胞术检测外周血淋巴细胞中CD4+CD25+T细胞的表达,同时检测患者CTL细胞的功能,对比观察2组患者的检测结果,分析和探讨结肠癌患者化疗/热化疗前后CD4+CD25+T细胞和CTL的变化及临床意义。结果化疗组患者治疗前后CD4+CD25+T细胞水平分别为(19±9)%和(19±3)%,无显著性差异(P>0.05);热化疗组患者治疗前后分别为(20±7)%和(15±8)%,有显著性差异(P<0.05);热化疗组患者治疗后的CD4+CD25+T细胞水平明显低于化疗组(P<0.05)。CTL细胞杀伤活性化疗组患者治疗前后分别为(10.4±2.2)%和(15.1±4.4)%,热化疗组患者治疗前后分别为(10.9±2.7)%和(17.5±3.8)%,2组比较治疗前后比较均有显著性差异(P均<0.05);热化疗组患者治疗后的CTL细胞杀伤活性显著优于化疗组(P<0.05)。结论热化疗可明显改善结肠癌患者的免疫抑制状态,增强患者CTL细胞的杀伤活性,可提高患者的临床治疗效果,改善预后,值得临床推广应用。

Objective It is to investigate the changes and clinical significance of CD 4 ＋CD25 ＋regulatory T cells and cytotoxic T cell in patients with colon cancer treated by chemotherapy or thermochemotherapy .Methods 68 patients with colon cancer were collected and divided into chemotherapy group with 34 cases and thermochemotherapy group with 34 cases, CD4^＋CD25^＋regulatory T cells in peripheral blood before and after treatment were measured by flow cytometry , and the killing function of cytotoxic T cell was detected at the same time .The test results of two groups were compared , and the changes and clinical significance of CD 4＋CD25 ＋regulatory T cells and cytotoxic T cell in patients with colon cancer treated by chemotherapy or thermochemotherapy were analyzed and discussed .Resul ts The level of CD4^＋CD25^＋regulatory T cells , chemotherapy group before and after treatment respectively was 19 ±9 and 19 ±3, there was no significant difference （P〉0.05）.Thermochemo-therapy group before and after treatment respectively was 20 ±7 and 15 ±8, There was significant difference（P〈0.05）.The change of CD4^＋CD25^＋regulatory T cells after treatment of thermochemotherapy group was significantly lower than chemotherapy group （P〈0.05）.The killing function of cytotoxic T cell, chemotherapy group before and after treatment respectively was 10.4 ±2.2 and 15.1 ±4.4, thermochemotherapy group respectively was 10.9 ±2.7 and 17.5 ±3.8, there was no significant difference between them in both groups （P〈0.05）.The change of killing function of cytotoxic T cell after treatment of ther-mochemotherapy group was significantly better than chemotherapy group , （P〈0.05）.Conclusion Thermochemotherapy can significantly improve the status of immunesuppression in colon cancer patients and enhance killing function of cytotoxic T cell , and can improve the clinical effect and the prognosis , it is worth to be widely applied clinically .