宫颈癌患者外周血CD4＋CD25＋调节性T细胞及其Foxp3表达的临床意义

CD4+CD25+ Treg cells and Foxp3 expression play key roles in the pathogenesis of cervical carcinoma

目的评价宫颈癌患者外周血CD4+CD25+调节性T细胞(Regulatery T cell,Treg)及其Foxp3表达的临床意义。方法收集中国医科大学附属盛京医院自2012年1月至2013年6月手术治疗的早期宫颈癌患者(FIGO分期≤Ⅱ期)34例,高级别宫颈上皮内瘤变(CIN2/3)患者30例以及20例健康女性作为正常对照。流式细胞技术检测各研究组手术前、后及对照组外周血Treg及Foxp3+Treg细胞占CD4+T细胞比例,应用t检验和单因素方差法进行统计学分析。结果比较宫颈癌、CIN2/3及对照组外周血Treg及Foxp3+Treg细胞所占CD4+T细胞比例,各组间差异有统计学意义(P<0.05);术后早期(7d),宫颈癌及CIN2/3患者外周血Foxp3+Treg细胞所占比例较术前显著下降(P<0.05),但Treg细胞所占比例无显著性变化(P>0.05);术后恢复期(1个月),宫颈癌及CIN2/3患者外周血Foxp3+Treg细胞所占比例较术后早期无显著变化,但Treg细胞所占比例较术后早期显著性降低(P<0.05)。结论宫颈癌患者外周血Treg细胞及其Foxp3的表达均与病变程度相关;Treg细胞Foxp3的表达具有不稳定性;宫颈癌肿瘤微环境可能是维持Treg细胞分化增殖及Foxp3稳定表达的外在客观条件。

Objective The aim of the study was to evaluate the frequencies of CD4＋CD25＋ Treg cells and their Foxp3 expression in peripheral blood in cervical cancers. Methods Women with cervical cancer （FIGO stage I or IIA, 34 cases）, high- grade cervical intraepithelial neoplasia （CIN 2-CIN 3, 30 cases） and 17 normal controls were recruited in the study from January 2012 to June 2013. Flow cytometry was employed to measure the frequency of Treg cells and Foxp3＋Treg cells among CD4＋ T cells in peripheral blood. The means of frequency of Treg cells was compared among and within groups at special preoperative or postoperative time- point using one- way ANO- VA and t- test. Results Among cervical pathological changes, the frequency of Treg cells among CD4＋ T cells in the peripheral blood was elevated and correlated with the severity of the disease （P〈0.05）. Moreover, after surgi- cal operation, the frequency of Treg and Foxp3＋Treg cells decreased significantly （P〈0.05）. In detail, the de- crease of Foxp3＋Treg was early at 7th day fter surgery, but the Treg at 30th day sluggishly. Conclusions The frequencies of Treg cells in peripheral blood was positively related to the malignant degree of cervical lesions. Fur- thermore, the expression of Foxp3 from Treg cells in patients with cervical cancer was instability. The microenvi- ronment of cervical cancer may be pivotal to Treg cells for proliferation differentiation and the expression of Foxp3.