宫颈鳞癌患者放疗前后外周血中MDSC和调节性T细胞含量变化及其与放疗敏感性的关系

Changes of MDSC and regulatory T cells in peripheral blood of patients with cervical squamous cell carcinoma before and after radiotherapy and their correlations with the sensitivity to radiotherapy

目的：探讨宫颈鳞癌患者在放疗前后其外周血中髓系抑制性细胞（ MDSC）和调节性T细胞（ Treg）含量变化及其与临床病理特征、放疗敏感性之间的关系。方法临床收集自2011年3月至2015年3月病理诊断为宫颈鳞癌的患者65例,收集其放疗前、中、后7 d的外周血。利用流式细胞术检测患者经放疗前后外周血中MDSC和Treg细胞含量变化,并分析MDSC和Treg细胞含量变化与宫颈鳞癌患者临床病理间的关系、对放疗敏感性的影响及其相关性。结果宫颈鳞癌患者外周血中MDSC和Treg细胞含量显著高于健康人（P〈0.05）；而与放疗前相比,放疗中、后期宫颈鳞癌患者外周血中MDSC和Treg细胞含量逐渐降低（P〈0.05）；宫颈鳞癌患者放疗后外周血中MDSC含量与肿瘤分化程度、淋巴转移性、肿瘤大小、间质浸润深度、血管浸润性均相关（P〈0.05）；而Treg细胞含量变化也与肿瘤分化程度、淋巴转移性、间质浸润深度、血管浸润性相关（P〈0.05）；放疗敏感组宫颈鳞癌患者在放疗前、中、后外周血中MDSC和Treg细胞含量均显著低于不敏感组（P〈0.05）；宫颈鳞癌患者放疗前、中、后外周血中MDSC和Treg细胞含量变化具有相关性（r=0.695,0.677,0.595,P〈0.05）。结论放疗能够降低宫颈鳞癌患者外周血中MDSC和Treg细胞含量,而MDSC和Treg细胞含量变化影响宫颈鳞癌患者放疗疗效和敏感性,它们可作为检测宫颈鳞癌患者放疗敏感性的生物指标之一。

Objective To investigate the changes of myeloid suppressor cells （ MDSC） and regu-latory T （ Treg） cell in peripheral blood of patients with cervical squamous cell carcinoma before and after ra-diotherapy, and to analyze their correlations with clinicopathological characteristics and radiotherapy sensitiv-ity. Methods Sixty-five patients who were pathologically diagnosed as cervical squamous cell carcinoma during March 2011 to March 2015 were recruited in this study. Peripheral blood samples were collected be-fore, during and 7 days after the radiotherapy. The changes in the percentages of MDSC and Treg cells in the peripheral blood samples were detected by flow cytometry, and their correlation with the clinicopathologic characteristics of patients with cervical squamous cell carcinoma and their influences on radiotherapy sensitiv-ity were further analyzed. Results The percentages of MDSC and Treg cells in peripheral blood of patients with cervical squamous cell carcinoma were significantly higher than those in healthy people （P〈0. 05）. The percentages of MDSC and Treg cells in peripheral blood of patients with cervical squamous cell carcinoma gradually decreased during and after radiotherapy as compared with those before radiotherapy （P〈0. 05）. The percentages of MDSC in peripheral blood of patients with cervical squamous cell carcinoma were correla-ted with the degree of tumor differentiation, lymph node metastasis, tumor size, depth of stromal invasion and vascular invasion （P〈0. 05）. The changes in Treg cells were also correlated with tumor differentiation, lymph node metastasis, depth of stromal invasion and vascular invasion （P〈0. 05）. Compared with the pa-tients who were not sensitive to radiation, those who were sensitive to radiation showed lower percentages of MDSC and Treg cells in peripheral blood samples collected before, during and after radiotherapy （ P〈0. 05）. There were positive correlations between the percentages of MDSC and Treg cells in peripheral blood of patients with cervical squamous cell carcinoma before, during and after radiotherapy （r=0. 695, 0. 677, 0. 595;P〈0. 05）. Conclusion Radiotherapy could reduce the percentages of MDSC and Treg cells in pe-ripheral blood of patients with cervical squamous cell carcinoma, which influenced the efficacy and sensitivity of radiotherapy. Therefore, the percentages of MDSC and Treg cells could be used as potential biological in-dicators for evaluating the radiosensitivity of patients with cervical squamous cell carcinoma.