乳腺癌内分泌治疗对髓系抑制性细胞的影响

Effect of endocrine therapy on myeloid-derived suppressor cell in patients with breast cancer

目的分析乳腺癌内分泌治疗药物他莫昔芬和来曲唑对髓系抑制性细胞(MDSC)数量及功能的影响。方法采用简单随机化分组法将53例接受术后辅助治疗的乳腺癌患者随机分为他莫昔芬组(接受他莫昔芬治疗)22例和来曲唑组(接受来曲唑治疗)31例。采用流式细胞术检测两组患者内分泌治疗前及治疗后6个月的外周血MDSC的相对数和绝对数;应用体外培养体系分析并比较两组MDSC对T细胞增殖水平的影响。结果内分泌治疗前,他莫昔芬组与来曲唑组患者的MDSC相对数、绝对数比较,差异均无统计学意义(P﹥0.05);治疗6个月后,来曲唑组患者的MDSC相对数、绝对数分别为(3.09±1.91)%、(1.73±0.35)×106/ml,均明显低于他莫昔芬组的(9.65±3.50)%、(2.92±1.18)×106/ml,差异均有统计学意义(P﹤0.01)。来曲唑组患者的外周血经MDSC处理后CD3+T细胞的增殖水平为(65.93±17.48)%,明显高于他莫昔芬组的(30.25±4.94)%,差异有统计学意义(P﹤0.01)。结论与他莫昔芬比较,乳腺癌患者术后接受来曲唑治疗,可降低MDSC的数量并抑制其功能。

Objective To analyze the influences of endocrine therapy using tamoxifen and letrozole on myeloid-derived suppressor cell (MDSC) of patients with breast cancer.Method The research included 53 patients who received postoperative adjuvant endocrine therapy,and were randomly divided into tamoxifen group (receiving tamoxifen,n=22) or letrozole group (receiving letrozole,n=31).The relative percentage and absolute count of peripheral MDSC before endocrine therapy and in 6 months after endocrine therapy in both groups were determined by flow cytometry;in vitro culture system was applied to determine and compare the impact of MDSC on T cell proliferation in the two groups.Result Before endocrine therapy,the relative percentage and absolute count of MDSC in tamoxifen group and letrozole group were of no statistically significant difference (P>0.05);in 6 months after therapy,the relative percentage and absolute count of MDSC in letrozole group were (3.09±1.91)% and (1.73±0.35)×10^6/ml,which were significantly lower compared with the (9.65±3.50)% and (2.92±1.18)×10^6/ml in tamoxifen group,showing statistically significant differences (P<0.01). The CD3^+T cell proliferation rate in the peripheral blood treated with MDSC in letrozole group was (65.93±17.48)%,and it was evidently higher than that in tamoxifen group at (30.25±4.94)%,with statistically significant difference observed (P<0.01).Conclusion Compared with tamoxifen,letrozole as the postoperative adjuvant therapy for cancer patients may effectively lower the MDSC count and reduce its function.