Treg、NK细胞联合免疫球蛋白及肿瘤标志物评估化疗对进展期胃癌免疫功能影响

Influences of Treg,NK cells,immunoglobulin and tumor markers evaluating chemotherapy effects on immune function of advanced gastric cancer

目的分析调节性T细胞(Treg细胞)、自然杀伤细胞(NK细胞)联合免疫球蛋白及肿瘤标志物评估化疗对进展期胃癌(AGC)免疫功能影响。方法选取2017年10月至2019年5月广西科技大学第二附属医院化疗AGC患者66例为胃癌组,根据化疗疗效分为有效组32例、稳定组20例、无效组14例,同时选取同期健康者40例为正常组。比较研究对象的Treg细胞、NK细胞、免疫球蛋白(IgA、IgG、IgM)以及相关肿瘤标志物(CEA、CA199、CA242)在化疗前后变化情况。结果胃癌组的Treg细胞、免疫球蛋白(IgA、IgG、IgM)以及相关肿瘤标志物(CEA、CA199、CA242)水平明显高于正常组(P<0.05),而NK细胞水平明显低于正常组(P<0.05);胃癌组患者总有效率为48.48%;与化疗前比较,有效组、稳定组患者经2个疗程化疗后的Treg细胞、免疫球蛋白以及肿瘤标志物水平明显降低(P<0.05),而NK细胞水平明显上升(P<0.05),且以上指标改善明显优于无效组(P<0.05);Treg细胞、NK细胞、免疫球蛋白以及肿瘤标志物联合的灵敏度、特异度、准确率分别高达89.39%、96.97%、92.42%,高于其他指标(P<0.05)。结论 AGC患者在化疗后的Treg细胞、NK细胞、免疫球蛋白以及肿瘤标志物水平有明显的变化,可以作为评估化疗疗效的诊断方法,且以上指标联合检测具有较高的灵敏度、特异性、准确率。

Objective To analyze the influences of regulatory T(Treg) cells,natural killer(NK) cells,immunoglobulin and tumor markers evaluating the chemotherapy effect on immune function of advanced gastric cancer(AGC).Methods Sixty-six patients with AGC treated by chemotherapy in the Second Affiliated Hospital of Guangxi University of Science and Technology from October 2017 to May 2019 were selected as study objects(gastric cancer group) and subdivided into effective group(n=32),stable group(n=20) and ineffective group(n=14) according to the efficacy of chemotherapy.At the same time,40 healthy persons were selected as control group.The changes of Treg cell,NK cell,immunoglobulins(IgA,IgG,IgM) and related tumor markers [serum carcinoembryonic antigen(CEA),carbohydrate chain antigen(CA)199,CA242]before and after chemotherapy were observed and compared among the groups.Results The levels of Treg cells,immunoglobulins(IgA,IgG,IgM),CEA,CA199,CA242 in gastric cancer group were significantly higher than those in control group(all P<0.05),while NK cell level was significantly lower than that in control group(P<0.05).The total effective rate was 48.48% in gastric cancer group.After two courses of chemotherapy,the levels of Treg cells,immunoglobulins and tumor markers significantly decreased,and the level of NK cells increased in effective and stable groups compared with pre-chemotherapy(P<0.05).The above indicators got significantly improved in effective and stable groups compared with ineffective group(all P<0.05).The sensitivity,specificity and accuracy of the combined detection of Treg cells,NK cells,immunoglobulins and tumor markers were 89.39%,96.97% and 92.42%,respectively and were higher than other indicators(all P<0.05).Conclusion For AGC patients after chemotherapy,the obvious changes of Treg cells,NK cells,immunoglobulins and tumor markers can be used as the indicators evaluating the efficacy of chemotherapy,and the combined detection of the above indicators has higher sensitivity,specificity and accuracy.