胃癌患者外周血CD8^+PD-1^+T细胞的表型、功能及临床意义

Phenotype,function and clinical significance of peripheral blood CD8^+PD-1^+T cells in patients with gastric cancer

目的探讨CD8^+程序性细胞死亡受体1(PD-1)^+T细胞在胃癌患者外周血中的表型、功能及其与临床分期的相关性。方法收集2019年7月至2020年1月陆军军医大学第一附属医院普外科31例胃癌患者(胃癌组)的外周血,采用流式细胞术检测CD8^+PD-1^+T细胞的比例及其免疫学表型和功能,分析CD8^+PD-1^+T细胞的比例与胃癌患者临床分期的相关性,另选31例体检健康者外周血作为对照组。结果与对照组比较,胃癌组患者外周血中CD8^+PD-1^+T细胞的比例明显增加,差异有统计学意义(7.39%vs.14.67%,P<0.01);与胃癌患者自身外周血中CD8^+PD-1-T细胞比较,CD8^+PD-1^+T细胞主要属于中心/效应记忆型细胞(CD45RA-CD27^+/-),且低表达效应性细胞因子干扰素-γ(INF-γ)和肿瘤坏死因子α(TNF-α)在两种细胞中的表达水平比较差异有统计学意义(42.24%vs.35.64%和28.92%vs.22.45%,P<0.01);与早期胃癌患者比较,晚期胃癌患者外周血中的CD8^+PD-1^+T细胞比例明显增加(11.77%vs.17.05%,P<0.01)。结论外周血中CD8^+PD-1^+T细胞应答与胃癌分期密切相关。

Objective To explore the phenotype,function of peripheral blood CD8^+PD-1^+T cells in the patients with gastric cancer(GC)and their correlation with the clinical stage.Methods The peripheral blood of 31 patients with GC in the general surgery department of the First Affiliated Hospital of Army Military Medical University from July 2019 to January 2020 was collected.The proportion,immunological phenotype and function of CD8^+PD-1^+T cells were analyzed by adopting the flow cytometry.The correlation between the proportion of CD8^+PD-1^+T cells and the clinical stage in the patients with GC was analyzed.The peripheral blood from 31 subjects undergoing physical examination was selected as the control group.Results Compared with the control group,the proportion of peripheral blood CD8^+PD-1^+T cells in the patients with GC was significantly increased,and the difference was statistically significant(7.39%vs.14.67%,P<0.01);compared with peripheral blood CD8^+PD-1^+T cells in the patients with GC,the CD8^+PD-1^+T cells mainly belonged to central/effector memory cells(CD45RA-CD27^+/-),but showed the low expression of effector cytokine INF-γand TNF-α(42.24%vs.35.64%and 28.92%vs.22.45%,P<0.01);compared with the early gastric cancer patients,the proportion of CD8^+PD-1^+T cells in the patients with advanced stage of gastric cancer was significantly increased(11.77%vs.17.05%,P<0.01).Conclusion The response of peripheral bloodCD8^+PD-1^+T cells is closely related to GC stage.