食管癌患者手术前后外周血T淋巴细胞亚群、NK细胞的测定及临床意义

Clinical Significance of Detecting T Lymphocyte Subsets and NK Cells and IL-12 in Peripheral Blood of Patients with Esophageal Carcinoma Before and after Surgery

目的探讨检测食管癌患者手术前后外周血T淋巴细胞亚群、自然杀伤细胞(NK)水平变化,从免疫生物学角度探讨食管癌患者手术前后免疫功能的变化。方法以26例健康体检者为对照组,96例食管癌患者为观察组,采用流式细胞仪检测对照组和食管癌患者手术前1天、术后第3天、术后第10天的外周血T淋巴细胞亚群CD3^+T淋巴细胞(CD3^+)、CD4^+T淋巴细胞(CD4^+)、CD8^+T淋巴细胞(CD8^+)、NK细胞(NK)的水平。结果观察组术前、术后第3天及术后第10天外周血CD3^+、CD4^+、NK、CD4^+/CD8^+比值明显低于对照组(P<0.05),CD8^+明显高于对照组(P<0.05)。食管癌组术后第3天与术前各指标差异无统计学意义(P>0.05)。食管癌组术后第10天CD3^+、NK较术前及术后第3天明显升高(P<0.05),CD4^+、CD4^+/CD8^+比值较术前明显升高(P<0.05),术后第10天CD8^+水平较术前、术后第3天明显降低(P<0.05)。食管癌组CD3^+、CD8^+与年龄、分化程度及浸润深度有关(P<0.05),而与性别、KPS评分、肿瘤部位、病理形态、病变长度、有无淋巴结转移、病理类型均无相关性,差异均无统计学意义(P>0.05)。结论食管癌患者免疫功能受到抑制,手术解除肿瘤负荷后患者免疫状态改善;T淋巴细胞亚群水平可能与食管肿瘤进展程度有关;T淋巴细胞亚群、NK在食管癌患者免疫监测中具有一定价值。

Objective To investigate the clinical significance of T lymphocyte subsets, NK cells level in the patients with esophage- al carcinoma（EC） before and after operation. To explore the changes of the immune function of esophageal patients before and after surgery from the perspective of immune biology. Method Twenty-six cases of healthy control and 96 patients with EC were included in the study. The T lymphocyte subsets （ CD3^＋ ,CD4^＋ ,CD8^＋ ） and NK cells levels were reflected indirectly through the flow cytometry, the blood sam- ples were collected at 1 day before operation, the third day and 10th day after surgery. Results The levels of CD3^＋ cells, CD4 ^＋ cells, NK cells and CD4^＋/CD8^ ＋ ratio at the 1 day before operation（BO）, third day postoperative（3DP） and 10th day postoperative group （10DP） were apparently lower than healthy control（HC） （P 〈 0.05 ） ,and the level of CD8^＋ cells were significantly higher than HC （P 〈 0.05 ）. The index between BO and 3DP had no differences statistical significance （P 〉 0.05 ）. The expressions of CD3 ^＋ cells and NK cells in 10DP were significantly higher than those of in BO and 3DP （ P 〈 0.05 ） , CD4^ ＋ cells and CD4 ^＋/CD8^ ＋ ratio were significantly higher than BO （P 〈 0.05 ） , the expression of CD8^＋ cells was significantly lower than BO and 3DP（ P 〈 O. 05 ）. The levels of CD3 ^＋ cells and CD8^＋ cells were significant correlation with age, histological grade, depth of invasion （P 〈 0.05 ） , but had no correlation with gen- der, KPS grade, tumor site, pathology morphological, tumor length, lymph node metastasis and pathological type （ P 〉 0.05 ）. Conclu- sion Their immune function were restrained,who with EC,and their immune status were improved after suigery. The T lymphocyte sub- sets might be associated with esophageal tumor progression. Detection T lymphocyte subsets and NK ceils might have a certain value in monitoring the immune function of patients with esophageal cancer.