膀胱癌患者外周血中IL-2、IFN-γ、TNF-α的表达及临床意义

Study on the clinical significance of expression of serum levels of IL- 2,IFN- γ and TNF- α in patients with bladder cancer

目的探讨膀胱癌患者外周血中白细胞介素2(IL-2)、γ干扰素(IFN-γ)、肿瘤坏死因子α(TNF-α)的表达水平及临床意义。方法选择60例膀胱移行细胞癌患者为研究对象,病理分级:I级26例,II-III级34例;临床分期[1]:Tis-T1期24例;T2-T4期36例。选择40例膀胱良性病变患者为疾病对照组。另选择健康者60例为对照组。采用ELISA方法检测入组对象IL-2、IFN-γ、TNF-α水平。结果膀胱癌组血清TNF-α水平高于膀胱良性病变组和对照组,差异有统计学意义(P<0.01),膀胱良性病变组和对照组血清TNF-α水平无显著差异(P>0.05),膀胱癌组血清IL-2、IFN-γ水平低于膀胱良性病变组和对照组,差异有统计学意义(P<0.01),膀胱良性病变组和对照组血清IL-2、IFN-γ水平无显著差异(P>0.05);膀胱癌不同病理分级之间血清IL-2、IFN-γ、TNF-α水平存在明显差异,随着膀胱癌病理分级的升高,血清IL-2、IFN-γ水平呈下降趋势,TNF-α水平呈上升趋势,三组间两两比较差异有统计学意义(P<0.01);随着膀胱癌临床分期的升高,血清IL-2、IFN-γ水平呈下降趋势,TNF-α水平呈上升趋势,三组间两两比较差异有统计学意义(P<0.01);IL-2、IFN-γ水平与膀胱癌病理分级、临床分期均呈负相关(P<0.05);TNF-α水平与膀胱癌病理分级、临床分期呈正相关(P<0.05);IL-2、IFN-γ、TNF-α与年龄、病程、BMI等因素无明显相关性(P>0.05)。结论 TNF-α在膀胱癌患者外周血中呈现高表达,IL-2、IFN-γ在膀胱癌中低表达,IL-2、IFN-γ、TNF-α与膀胱癌的发生、发展有关。

Objective To explore the clinical significance of serum levels of IL - 2,IFN - γ and TNF - α in patients with bladder canc-er. Methods A total of 60 patients with bladder cancer during January 2911 to June 2014 were selected in this study. The pathological classifica-tion of bladder cancer in these 60 cases was as follows：26 cases with grade I,and 34 cases with grades II - III. Their clinical stages were 24 cases in Tis - T1 stages;and 36 cases in T2 - T4 stages. 40 patients with benign lesions in urinary bladder were selected as disease control group, and 60 healthy persons were selected as control group. The serum levels of IL - 2,IFN - γ and TNF - α were detected and correlation analysis with age,course of the disease,pathological classification of bladder cancer,clinical stages and BMI had been made. Results In patients with bladder cancer group,the serum level of TNF - α was higher than that of patients in bladder benign lesion group and control group,and the differ-ence was statistically significant（ P 〈 0. 01）. The diference in serum levels of TNFα between benign bladder lesion group and control group was not significant（ P 〉 0. 05）. The difference in serum level of IL - 2 and IFN - γ between bladder benign lesion group and control group was statis-tically significant（ P 〈 0. 01）,and the difference in serum levels of IL - 2 and IFN - γ between bladder benign lesion group and control group was not significant（ P 〉 0. 05）. The difference in serum levels of IL - 2,IFN - γ and TNF - α in patients with bladder cancer in different path-ological grades was significant,following the increase of grade of pathological classification of bladder cancer,the serum levels of IL - 2 and IFN- γ were declined,and the serum level of TNF - α was increased（ P 〈 0. 01）. The difference in clinical stages of bladder cancer among serum levels of IL - 2,IFN - γ and TNF - α was significant. Following the increase of clinical stages of bladder cancer,serum levels of IL - 2 and IFN- γ were declined,serum level of TNF - α was increased（ P 〈 0. 01）. Serum levels of IL - 2 and IFN - γ were negatively correlated with patho-logical grades and clinical stages of bladder cancer（ P 〈 0. 05）. Serum level of TNF - α was positively correlated with the pathological graades and clinical stages of bladder cancer（ P 〈 0. 05）. Serum levels of IL - 2,IFN - α and TNF - α were not obviously correlated with factors as age, course of the disease and BMI（ P 〉 0. 05）. Conclusion The expression of TNF - α is high,and the expression of IL - 2 and IFN - γ is low in patients with bladder cancer,and serum. levels of IL - 2,IFN - γ and TNF - α are closely correlated with the degree of malignancy and progress of bladder cancer.