LAP＋CD4＋Treg细胞在结直肠癌患者外周血中的分布及意义

Distributions and significance of LAP ＋ CD4 ＋ Treg cells in the peripheral blood of patients with colorectal cancer

目的探讨LAP＋CD4＋Treg细胞在结直肠癌患者外周血中的分布及其与患者临床病理因素的关系。方法采用回顾性病例对照研究方法。收集2014年4—10月广西医科大学附属第一医院收治的40例行结直肠癌根治术患者和同期20例健康志愿者的临床资料。采用流式细胞仪检测外周血LAP＋CD4＋Treg细胞比例。观察指标：（1）结直肠癌患者及健康志愿者外周血LAP＋CD4＋Treg细胞比例。（2）结直肠癌患者临床病理因素与外周血LAP＋CD4＋Treg细胞比例的关系。（3）对与结直肠癌患者外周血LAP＋CD4＋Treg细胞比例相关的临床病理因素进行进一步定量相关性分析。正态分布的计量资料以z±S表示，组间比较采用t检验。采用Pearson检验进行相关性分析。结果（1）流式细胞仪检测外周血LAP＋CD4＋Treg细胞比例情况：结直肠癌患者外周血LAP＋CD4＋Treg细胞比例为9．4％±2．9％，健康志愿者为1．5％±0．7％，两者比较，差异有统计学意义（i=12．275，P〈0．05）。（2）结直肠癌患者临床病理因素与外周血LAP＋CD4＋Treg细胞比例的关系：血清CEA〈5．0μg／L的结直肠癌患者外周血LAP＋CD4＋Treg细胞比例为8．5％±3．2％，≥5．0μg／L患者为12．3％±3．0％；Dukes分期为A～B期患者为8．1％±1．1％，C～D期患者为10．8％±2．0％；有淋巴结转移的患者为11．4％±2．0％，无淋巴结转移的患者为9．3％±2．1％。不同血清CEA、Dukes分期、淋巴结转移的结直肠癌患者外周血LAP＋CD4＋Treg细胞比例比较，差异均有统计学意义（t=2．783，-5．376，3．276，P〈0．05）。（3）相关性分析：结直肠癌患者血清CEA与外周血LAP＋CD4＋Treg细胞比例呈正相关，差异有统计学意义（r=0．543，P〈0．05）。结论LAP＋CD4＋Treg细胞在结直肠癌患者外周血中比例增加，且不同血清CEA、Dukes分期和淋巴结转移患者，外周血LAP＋CD4＋reg细胞比例不同。患者血清CEA与外周血LAP＋CD4＋Treg细胞比例呈正相关。

Objective To explore the distributions of LAP＋ CD4 ＋ Treg cells in the peripheral blood of patients with colorectal cancer and its relationship with the clinicopathological factors. Methods The retrospective case-control study was adopted. The clinical data of 40 patients undergoing radical resection of colorectal cancer and 20 healthy volunteers who were admitted to the First Affiliated Hospital of Guangxi Medical University between April 2014 and October 2014 were collected. The proportion of LAP＋ CD4 ＋ Treg cells in the peripheral blood was detected by flow cytometry. Analysis indicators included ： （ 1 ） proportion of LAP＋ CD4 ＋ Treg cells in the peripheral blood between patients with colorectal cancer and healthy volunteers, （2） relationship between clinieopathologieal factors and proportion of LAP＋ CD4＋ Treg cells in the peripheral blood, （3） correlation analysis of quantitative data on the clinicopathologieal factors related with proportion of LAP ＋ CD4 ＋ Treg cells in the peripheral blood. Measurement data with normal distribution were presented as x ±s, and comparison between groups was analyzed using the t test. Correlation analysis was done using the Pearson test. Results （ 1 ） Results of flow cytometry showed that proportion of LAP ＋ CD4 ＋ Treg cells in the peripheral blood was 9.4% ＋ 2.9% in patients with colorectal cancer and 1.5% ±0.7% in healthy volunteers, with a statistically significant difference （ t = 12. 275, P 〈 0.05）. （2） Relationship between clinicopathological factors and proportion of LAP ＋ CD4 ＋Treg cells in the peripheral blood ： proportion of LAP ＋CD4 ＋Treg cells in the peripheral blood in patients with colorectal cancer was 8.5% ± 3.2% with serum carcinoembryonic antigen （CEA） 〈 5.0 μg/L, 12.3% ± 3.0% with serum CEA≥5.0 p.g/L, 8.1%＋1.1% in stage A-B of Dukes staging, 10.8%＋2.0% in stage C-D of Dukes staging, 11.4%±2.0% with lymph nodes metastasis and 9.3%＋2.1% without lymph nodes metastasis, showing statistically significant differences in the different levels of CEA, Dukes staging and lymph node metastasis （ t = 2. 783, - 5. 376, 3. 276, P 〈 0.05 ）. （ 3 ） Correlation analysis ： there was a positive correlation between serum CEA of patients with colorectal cancer and proportion of LAP＋ CD4 ＋ Treg cells in the peripheral blood, with a statistically significant difference （r = 0. 543, P 〈 0.05）. Conclusions The proportion of LAP＋ CD4 ＋ Treg cells in the peripheral blood of patients with colorectal cancer is increased, and it is also different among patients with different Dukes staging and lymph node metastasis. There is a positive correlation between serum CEA of patients with colorectal cancer and proportion of LAP＋ CD4 ＋ Treg cells in the peripheral blood.