肿瘤微环境中CD4^+Foxp3^+Treg对鼻咽癌患者预后影响

Effect of CD4^+Foxp3^+Treg on Prognosis of Nasopharyngeal Carcinoma Patients in Tumor Microenvironment

目的探讨肿瘤微环境中CD4^+Foxp3^+Treg对鼻咽癌患者的预后影响。方法选取2011年2月-2013年2月于我院收治的127例鼻咽癌患者为研究对象,应用流式细胞仪检测两组血清CD3^+、CD4^+、CD8^+、CD4^+/CD8^+以及Th17在CD4^+T细胞比例等指标,依据CD4^+/CD8^+值分为正常组以及异常组,并应用免疫组化法检测患者癌组织CD4、Foxp3以及IL-17,另依据CD4^+Foxp3^+Treg表达水平划分为低表达组与高表达组,应用Kaplan-Meier法比较生存情况并进行预后的多因素分析。结果异常组CD3^+、CD4^+、CD4^+/CD8^+、Th17在CD4^+T细胞比例显著低于正常组,CD8^+显著高于正常组(P<0.05);CD4^+Foxp3^+Treg与患者无瘤生存时间呈显著正相关(P<0.05),与总体生存时间呈正相关,但无统计学意义(P>0.05);CD4^+/CD8^+异常患者的5年总生存率67.95%显著低于正常患者5年总生存率89.80%(P<0.05);T分期、CD4^+/CD8^+表达水平以及Th17是影响鼻咽癌预后的独立影响因素(P<0.05);CD4^+Foxp3^+Treg与肿瘤转移复发密切相关(P<0.05)。结论鼻咽癌患者CD4^+/CD8^+、Th17水平明显降低,其水平异常表达可严重影响患者预后,肿瘤间质中CD4^+Foxp3^+Treg细胞数量增多与预后呈正相关,并与肿瘤转移复发密切相关。

Objective To investigate the prognostic significance of CD4^+Foxp3^+Treg in patients with nasopharyngeal carcinoma.Methods 127 patients with nasopharyngeal carcinoma admitted to our hospital from February 2011 to February 2013 were selected as the research subjects,the serum CD3^+,CD4^+,CD8^+,CD4^+/CD8^+and the ratio of Th17 to CD4^+T cells in two groups were detected by flow cytometry,they were divided into normal group and abnormal group according to CD4^+/CD8^+value,immunohistochemical method was used to detect the CD4,Foxp3 and IL-17 in patients with cancer,according to the level of CD4^+Foxp3^+Treg expression,they were divided into low expression group and high expression group,Kaplan-Meier method was used to compare survival,and multivariate analysis of prognosis was carried out.Results The proportion of CD3^+,CD4^+,CD4^+/CD8^+,Th17 in abnormal group was significantly lower than that in normal group,and CD8^+was significantly higher than that in normal group(P<0.05);there was a significant positive correlation between CD4^+Foxp3^+Treg with tumor free survival time(P<0.05),which was positively correlated with overall survival time,but not statistically significant(P>0.05);the 5 year overall survival rate of patients with CD4^+/CD8^+abnormality was 67.95%,which was significantly lower than 89.80%of normal patients(P<0.05);T staging,CD4^+/CD8^+expression level and Th17 were independent influencing factors for nasopharyngeal carcinoma(P<0.05);CD4^+Foxp3^+Treg was closely related to tumor metastasis and recurrence(P<0.05).Conclusion The levels of CD4^+/CD8^+and Th17 in nasopharyngeal carcinoma patients are decreased significantly,and the abnormal expressions can seriously affect the prognosis of the patients,the increase of CD4^+Foxp3^+Treg cells number in the tumor interstitium is positively correlated with the prognosis,and was closely related to the metastasis and recurrence of the tumor.