调强放疗前后外周血淋巴细胞及其亚群的变化分析

Analysis on the changes of lymphocytes and their subpopulations in the peripheral blood of patients with carcinoma after intensity modulated radiotherapy

目的分析肿瘤患者调强放疗(IMRT)前后外周血淋巴细胞和亚群的变化,探讨该变化对疗效的影响。方法采用流式细胞仪(FCM)检测183例常见恶性肿瘤患者IMRT前后的外周血,其中66例行免疫功能检测,117例行调节性T(Treg)细胞检测。结果 IMRT可降低外周血中的淋巴细胞总数、CD3^+T细胞、CD4^+辅助性T(Th)细胞、CD4^+CD25^+CD127^(low)Treg细胞以及B细胞的百分比,而CD8^+抑制性/细胞毒性T(Ts/Tc)细胞和自然杀伤(NK)细胞的百分比升高,CD4^+/CD8^+比值降低。结论 IMRT可降低淋巴细胞总数,并引起细胞亚群的再分布,在IMRT的过程中和结束的早期给予免疫调节治疗,可能有利于免疫平衡的恢复。

Objective To analyze the changes of lymphocytes and their subsets in the peripheral blood of patients with carcinoma before and after intensity modulated radiotherapy( IMRT),and discuss the influence of these changes on therapeutic effects. Methods Flow cytometer( FCM) was used to analyze the blood samples from 183 patients,of which 66 and 117 blood samples were utilized for analyses of immunologic function and regulatory T( Treg) cells respectively. Results Total counts of lymphocytes,the percentages of CD3^+T cells,CD4^+ helper T( Th) cells,CD4^+CD25^+CD127lowTreg cells and B cells in peripheral blood were reduced by IMRT. Conversely,the percentages of CD8^+ suppressor T( Ts)/cytotoxic T( Tc) cells and nature killer( NK) cells were increased.The ratio of CD4^+ cells and CD8^+ cells was also reduced by IMRT. Conclusion IMRT can decrease the number of lymphocytes in peripheral blood,and lead to the redistribution of lymphocytes subpopulations. It is therefore important that the recovery of immunological homeostasis may be helped by immunological modulating therapies during and in an early stage after IMRT.