以核仁形成区银染蛋白等指标评价肿瘤患者免疫状况的研究

Assessment of immune status of tumor patients by Ag-NORs of peripheral T lymphocytes, T cell subsets and plasma cytokines

目的 比较分析各项免疫检测指标在肿瘤患者的变化情况 ,寻找可以真实反映肿瘤患者机体免疫状况相对理想的指标。方法 运用细胞培养、细胞化学银染技术、酶联免疫吸附测定、单向免疫扩散测定、KL型免疫图象分析系统及流式细胞仪等技术方法 ,分别检测健康人和恶性肿瘤患者外周血T淋巴细胞核仁形成区银染蛋白 (argyrophilicnuclearorganizerregionassociatedproteins,Ag NORs)、T细胞亚群及血浆细胞因子等项目。结果 与健康人比较 ,各种类型肿瘤患者外周血T细胞Ag NORs降低。胃肠道恶性肿瘤外周血T淋巴细胞Ag NORs、CD3、CD4显著减少 ,血浆TH1型细胞因子IL 2和IFN γ降低 ,TH2型细胞因子IL 6升高。外周血T淋巴细胞Ag NORs变化与患者化疗和术后的全身综合状况的恢复时相大致相符。经过对衡量人罹患恶性肿瘤时免疫状态作用的各项免疫指标进行筛选比较 ,单项指标中血浆细胞因子最佳。外周血T淋巴细胞Ag NORs优于T细胞亚群及NK细胞。联合应用 ,以T淋巴细胞Ag NORs、IFN γ及IL 2三项指标的检测结果为最佳 ,其判断恶性肿瘤发生可能性的敏感性和特异性分别达 93.1%和 96 .7%。结论 外周血T细胞Ag NORs可以作为反映患者机体免疫状况的一个具有临床应用前景的指标。外周血T淋巴细胞Ag NORs、IFN γ及IL

Objective To identify the changes of cellular immunity in malignant patients, and to look for the relatively ideal indicators which can really reflect immune ability of malignant patients. Methods Cell culture, cellular chemistry silver staining, ELISA, KL immune image analysis system and flow cytometry were used. Results Ag-NORs (argyrophilic nuclear organizer region associated proteins) of peripheral T lymphocytes, T cell subsets, plasma cytokines were examined in healthy people and malignant patients. Ag-NORs of peripheral T lymphocytes, CD3, CD4, NK cell, plasma T H1 cytokines: IL-2 and IFN-γ all decreased markedly, but T H2 cytokines: IL-6 increased. Ag-NORs of peripheral T lymphocytes not only reflect the low immune status of malignant patients, but also the changes according with the resume phase after chemotherapy or surgery. As an immune markers, plasma cytokine is the best and Ag-NORs of peripheral T lymphocytes is better than T cell subsets and NK cells. The combination of Ag-NORs in T cell, IFN-γ and IL-2 is the best, with sensitivity and specificity as 93.1% and 96.7% respectively. Conclusions Expression of Ag-NORs in T cells is an promising indicator to reflect immune status. Among these indicators, the combination of Ag-NORs in T cell, IFN-γ and IL-2 should be proferable than the others for estimating immune status. [