甲状腺肿瘤患者中辅助性T细胞22及白细胞介素-22的变化及意义

The abnormality and clinical significant of T helper 22 cells and interleukin-22 in patients with thyroid tumor

目的 检测甲状腺肿瘤患者外周血及肿瘤组织中辅助性T细胞22 （Th22）及白细胞介素（IL）-22的表达水平,探讨其与患者临床病理特征的关系.方法 选择56例原发甲状腺肿瘤患者和30例健康志愿者,采用流式细胞仪检测外周血Th22细胞水平,酶联免疫吸附试验法（ELISA）检测血清中IL-22表达水平,应用免疫组织化学双染色分析正常组织及肿瘤组织中Th22阳性细胞的浸润程度,分析这些参数与临床病理特征间的关系.结果 甲状腺肿瘤患者外周血中Th22细胞及IL-22水平分别为（1.74±0.27）％和（162.7±32.2） ng/L,显著高于对照组[（0.57±0.14）％,t=15.72,P＜0.01;（64.2 ±20.7） ng/L,t=11.31,P＜0.01];甲状腺癌患者的Th22细胞比例及IL-22水平明显高于甲状腺瘤患者[（2.21±0.34）％比（1.39±0.22）％,t=9.14,P＜0.01;（199.1±34.1）ng/L比（129.8±31.3） ng/L,t=6.79,P＜0.01].甲状腺肿瘤患者组织中Th22阳性细胞浸润率为56.25％,而对应正常组织为8.33％,差异有统计学意义（χ^2=8.167,P＜0.01）;甲状腺癌组织中Th22细胞浸润率为78.6％,甲状腺瘤组织为38.9％,差异有统计学意义（χ^2=5.039,P＜0.05）.外周血Th22细胞比例、IL-22的表达水平和肿瘤组织中Th22阳性细胞浸润程度与临床分期、淋巴结转明显相关（P＜0.05）,与年龄、性别、病理类型无明显相关（P＞0.05）.结论 甲状腺肿瘤患者外周血Th22细胞比例及血浆中IL-22水平显著升高,且与临床分期等病理特征明显相关,表明Th22细胞及IL-22参与甲状腺肿瘤的发生发展.

Objective To detect the expression of T helper cells 22 （Th22） in the peripheral blood and the level of interleukin （IL）-22 in the plasma and the Th22 cells in the tumor tissues of patients with thyroid tumor,and to analyze the relationship between Th22/IL-22 and clinical characteristics in the pathogenesis of laryngeal squamous cell carcinoma （LSCC）.Methods Fifty-six patients with thyroid tumor,and 30 healthy controls were included.Th22 cells in the peripheral blood were detected by flow cytometry,the concentrations of IL-22 in serum were measured by enzyme-linked immunosorbent assay （ELISA）,Double immunohistochemistry （IHC） was used to determine the Th22 cells in paraffin-embedded tissues,the relationship between Th22/IL-22 and clinical characteristics were analyzed.Results The level of Th22 cells in peripheral blood and IL-22 in the serum of patients with thyroid tumor were （1.74 ± 0.27） % and （162.7 ± 32.2） ng/L,respectively,significantly higher than that of healthy controls [（0.57±0.14）%,t=15.72,P〈0.01; （64.2±20.7） ng/L,t=ll.31,P〈0.01].Patients with thyroid carcinomas had higher Th22 cells and IL-22 levels than that of patients with thyroid adenomes [（2.21±0.34）% vs.（1.39±0.22）%,t=9.14,P〈0.01; （199.1 ±34.1） ng/Lvs.（129.8±31.3） ng/L,t =6.79,P 〈0.01].Compared with normal tissues,tumor tissues showed higher expression of CD4 ＋ IL-22 ＋ cells （56.25 % vs.8.33%,χ^2 =8.167,P 〈 0.01）.Compared with adenome tissues,carcinoma tissues showed higher expression of CD4 ＋ IL-22 ＋ cells （78.6% vs.38.9%,χ^2 =5.039,P 〈0.05）.The levels of Th22 cells in peripheral blood,IL-22 in serum and Th22 cells in tumor tissues was associated with tumor stage and lymph node metastasis （P 〈 0.05）.Conclusion There are higher quantification of Th22 cells and IL-22 in the peripheral blood and tumor tissues in patients with thyroid tumor and they have positive correlation with the clinical stage,Th22 cells and IL-22 may contribute to the disease progression and prognosis of thyroid tumor.