Foxp3及其调控的CD4^+CD25^+Treg细胞在肺腺癌患者中表达的规律及对患者生存的影响

Expression of Foxp3 and CD4^+CD25^+Treg cells in lung adenocarcinoma patients and the survival analysis of patients affected by them

目的探讨Foxp3及其调控的CD4^+CD25^+Treg细胞在肺腺癌患者中表达的规律及对患者生存的影响。方法 Western-blot法检测正常肺组织、肺腺癌、鳞癌组织(按Ⅰ、Ⅱ、Ⅲa分期分层)中Foxp3水平。免疫组化方法观察小细胞肺癌、腺癌、鳞癌中Foxp3蛋白表达情况;流式细胞法检测临床各期肺腺癌患者和健康人群血清中表达Foxp3的CD4^+CD25^+Treg细胞计数,并观察化疗及手术对肺腺癌患者血清中Foxp3水平的影响。使用Kaplan-Meier生存曲线分析血清中CD4^+CD25^+Treg细胞计数与肺腺癌患者生存周期之间的关系。结果肺腺癌各期患者Foxp3表达水平和血清中CD4^+CD25^+Treg细胞计数均明显高于健康人群,与肿瘤分期呈正相关,经手术或化疗干预后患者外周血清中细胞计数下降明显。细胞计数低于平均值或化疗后细胞计数变化值高于平均值的患者平均生存周期明显高于细胞计数值高于平均值或化疗后细胞计数变化值小于平均值的患者。结论 Foxp3调控的CD4^+CD25^+Treg细胞在肺腺癌的发生发展中可能起着重要的作用,对其深入研究将有助于肺腺癌的早期诊断,并可将其作为常规检查及监测患者预后的指标之一。

Objective To analyze the expression of Foxp3 and CD4^＋CD25^＋Treg cells in lung adenocarcinoma patients and the survival analysis of patients affected by them. Methods Western-blot was used to detect the levels of Foxp3 in normal lung tissues,lung adenocarcinoma,squamous cell carcinoma（ Ⅱ,Ⅰ,Ⅲa staging）. Expression of Foxp3 protein in small cell lung cancer,adenocarcinoma and squamous cell carcinoma was observed by immunohistochemistry. CD4^＋CD25^＋Treg cells counted by Flow cytometry method.Using Kaplan-Meier survival curves to analyze the relationship between serum CD4^＋CD25^＋Treg cells count and lung adenocarcinoma patients. Results lung adenocarcinoma patients with Foxp3 expression level in serum and count of CD4^＋CD25^＋Treg cells were significantly higher than those in healthy people,was positively correlated with tumor stage,cell count decreased significantly after surgery or chemotherapy intervention in patients. Cell count lower than the average value or chemotherapy after cell counting change value higher than the average value of patients＇ mean survival time was more than that the cell count higher than average or chemotherapy after cell counting change value less than the average value of patients. Conclusion Foxp3 and regulatory CD4^＋CD25^＋Treg cells may be one of the pathogenesis of lung adenocarcinoma,CD4^＋CD25^＋Treg cell counts could be a routine examination and as a forecast index of prognosis for adenocarcinoma patients.