肾癌根治术患者手术前后CD8^+CD28^-T细胞表达及临床意义

Expression and clinical significance of CD8^+CD28^-T cells for renal carcinoma patients underwent nephrectomy

目的探讨肾癌根治术患者手术前后CD8^+CD28^-T细胞表达及临床意义。方法收集52例接受根治术的肾癌患者作为观察对象,采用流式细胞术检测手术前后外周血CD8^+CD28^-T细胞、白介素10(IL-10)及转化生长因子β1(TGF-β1)含量;分析三者含量与肿瘤分期的相关性,并以肾错构瘤患者及正常人作为对照。结果肾癌患者CD8^+CD28^-T细胞、IL-10及TGF-β1均显著高于另外两组,但肾错构瘤患者与正常人之间均无统计学差异(P<0.05);术前III期患者CD8^+CD28^-T细胞、IL-10及TGF-β1显著高于I及II期(P<0.05);术后各期肾癌患者CD8^+CD28^-T细胞及TGF-β1含量均显著低于术前(P<0.05),但IL-10却与术前无统计学差异;术后III期患者CD8^+CD28^-T细胞、IL-10及TGF-β1显著高于Ⅰ及Ⅱ期患者(P<0.05),但术前及术后I及II期患者上述三项指标均无统计学差异。相关性分析显示CD8^+CD28^-T细胞、IL-10及TGF-β1与分期均呈显著正相关性(P<0.05),其相关程度由大至小依次为CD8^+CD28^-T细胞>TGF-β1>IL-10。结论CD8^+CD28^-T细胞及其细胞因子表达含量增多可能是肾癌的一个新免疫机制,前者可在一定程度上鉴别肾癌与良性肿瘤,且可以评价手术效果。

Objective To investigate the expression and clinical significance of CD8 ＋CD28-T cells for patients with renal carcinoma undergoing nephrectomy. Methods Fifty-two patients who underwent radical prostatectomy were collected as research objects（group A）. Flow cytometry was used to test peripheral blood CD8＋CD28-T cells before and after operation, interleukin 10（IL-10）, and transforming growth factor beta 1（TGF-beta 1） content. The correlation between the three levels and of tumor stage was analyzed. The patients with renal hamartoma（group B） and normal people（group C） served as controls. Results The CD8＋CD28-T cells number, expression of IL-10 and TGF-beta 1 in group A were significantly higher than the other two groups, but had no statistical difference between the group B and group C. Preoperative levels of CD8＋CD28-T cells, IL-10 and TGF-beta 1 in the patients with stage III were significantly higher than those with stage I and stage II（P 0.05）. Postoperative levels of CD8＋CD28-T cells,IL-10 were increased and TGF-beta 1 content was decreased in patients with stage III than that of preoperative period（P 0.05）, but no difference in patients with stage I and stage II between pre- and post-operation. Correlation analysis showed that the CD8＋CD28-T cells,IL-10 and TGF-beta 1 and tumor stage showed significant positive correlation（P 0.05） and the related degree was CD8＋CD28-T cells TGF-beta 1 IL-10. Conclusion The increases of CD8＋CD28-T cells and cytokines levels could be a new immune mechanism of kidney carcinoma, and the former could identify kidney cancer and benign tumor, evaluate the operation effect.