鼻咽癌患者放疗前、后外周血淋巴细胞亚群的变化研究

Changes of peripheral blood lymphocyte subsets in patients with nasopharyngeal carcinoma before and after radiotherapy

目的观察鼻咽癌患者放化疗前、后外周血淋巴细胞亚群的变化。方法应用流式细胞仪对40例健康正常人群(对照组)和32例鼻咽癌患者(鼻咽癌组)放化疗前、后的外周血T淋巴细胞亚群、B淋巴细胞及NK细胞等进行检测,并比较鼻咽癌患者放疗前后和健康人群的检测值。结果鼻咽癌组放疗前外周血中CD3+、CD4+、CD4+/CD8+、B细胞均值较对照组下降,差异均有统计学意义(t值分别为2.243、2.765、1.943、2.036,P值分别为0.020、0.009、0.031、0.028);外周血中CD8+、NK细胞均值较对照组升高,差异均有统计学意义(t值分别为-1.768、-2.865,P值分别为0.043、0.007);鼻咽癌组放疗后淋巴细胞亚群外周血中CD4+、CD4+/CD8+均值较放疗前下降,差异均有统计学意义(t值分别为5.219、5.665,P值分别为0.000、0.000);外周血中CD8+、B细胞均值较放疗前升高,差异均有统计学意义(t值分别为-2.959、-2.922,P值分别为0.004、0.004);鼻咽癌组放疗前后CD3+、NK细胞均值差异均无统计学意义(t值分别为1.576、-0.328,P值分别为0.117、0.703)。结论鼻咽癌患者免疫功能下降,外周血T、B淋巴细胞及NK细胞的检测对判断患者的免疫功能有参考作用。放疗可使鼻咽癌患者CD4+/CD8+明显下降,放疗期间应辅以免疫治疗。

Objective To observe the changes of immune functions in patients with nasopharyngeal carcino-ma （NPC）.To analyze the changes in cellular immune functions patients with NPC chemotherapy before and after chemoradiotherapy.Methods Flow cytometry was used to detect blood T lymphocyte subsets,B lymphocytes and NK cells of 40 cases of healthy people and 32 cases of patients with nasopharyngeal carci-noma before and after chemoradiotherapy.Comparisons were made in the testing results between patients with nasopharyngeal carcinoma before and after chemoradiotherapy and healthy people.Results CD3＋, CD4＋,CD4＋/CD8＋,B cells showed statistically significant differences between NPC patients before ra-diotherapy and healthy normal population control group,CD3＋,CD4＋,CD4＋/CD8＋,B cells had a downward trend （t values were 2.243,2.765,1.943,2.036,P values were 0.020,0.009,0.031,0.028） while CD8＋,NK cells had an upward trend （t values were -1.768,-2.865,P values were 0.043, 0.007）, which was statistically significant.CD4 ＋, CD4 ＋/CD8 ＋ were significantly different in lymphocyte subsets levels of peripheral blood NPC patients before and after radiotherapy,CD4＋,CD4＋/ 〈br〉 CD8＋ decreased gradually which had statistically significant difference （t values were 5.219,5.665,P val-ues were 0.000,0.000）;CD8＋,B cells rose gradually which had statistically significant difference （t val-ues were-2.959,-2.922,P values were 0.004,0.004）.There was no statistically significant difference in CD3＋,NK cells （t values were 1.576,-0.328,P values were 0.117,0.703）.Conclusion NPC patients show a low immune function,levels of Peripheral blood B and T lymphocyte subsets and NK cells are good references in j udging patient＆#39;s immune function.Radiotherapy significantly decreases the percentages of CD4＋/CD8.Therefore,radiotherapy should be supplemented by immunotherapy.