中晚期胃癌患者外周血T细胞亚群检测的临床意义

Detection of lymphocyte immune function in peripheral blood of patients with advanced gastric cancer

目的:研究胃癌患者外周血T淋巴细胞亚群变化的临床意义。方法:选取2015年10月至2016年5月北京世纪坛医院肿瘤内科收治的67例胃癌患者,抽取外周血,采用流式细胞术检测T细胞及其亚群,同时抽取外周血检测肿瘤标记物CEA、CA199,对结果进行分析比较,并对患者进行随访。结果:67例胃癌患者中,Ⅲ期患者Tc(CD8+CD28+)均值为12.3±5.1,Ⅳ期患者Tc(CD8+CD28+)均值为9.9±4.6,两者比较差异具有统计学意义(P=0.043);CEA升高的患者Tc(CD8+CD28+)均值为9.3±3.6,而CA199未升高的患者Tc(CD8+CD28+)均值为12.1±5.6(P=0.025)。CA199升高的患者Tc(CD8+CD28+)均值为9.3±4.2,而CEA未升高的患者Tc(CD8+CD28+)均值为12.1±5.3(P=0.029),Tc(CD8+CD28+)下降的患者较未下降的患者的总生存时间(overall survival,OS)降低(8.1个月vs.15.1个月,P=0.008)。结论:胃癌患者随着TNM分期的提高,其机体的细胞免疫功能呈现逐渐下降的趋势;CEA、CA199升高的患者Tc(CD8+CD28+)降低,二者呈负相关;Tc(CD8+CD28+)降低,患者的OS缩短。

Objective：To investigate the clinical significance of the changes of T lymphocyte subsets in the peripheral blood of patients with gastric cancer. Methods：The lymphocyte subsets in 67 patients with gastric cancer were analyzed with flow cytometry. CEA and CA199 from all patients were also detected. Results were statistically analyzed, and the patients were followed up. Results：The aver-age values of Tc （CD8＋CD28＋） in patients with stagesⅢandⅣgastric cancer were 12.3±5.1 and 9.9±4.6, respectively, with significant difference （P=0.043）. The average values of Tc （CD8＋CD28＋） in patients with elevated CEA and with normal CEA were 9.3±3.6 and 12.1± 5.6, respectively （P=0.025）. Similarly, the average values of Tc （CD8＋CD28＋） in patients with elevated CA199 and with normal CEA were 9.3±4.2 and 12.1±5.3, respectively （P=0.029）. The overall survival of patients with decreased Tc （CD8＋CD28＋） was lower than that of patients with normal Tc （CD8＋CD28＋） （8.1 vs. 15.1 months, P=0.008）. Conclusion：The cellular immune function of patients with gastric cancer gradually decreased with the progression of TNM. Higher CA199 and CEA values indicated lower average values of Tc （CD8＋CD28＋）. The overall survival of patients with decreased Tc （CD8＋CD28＋） was lower.