摘要
目的研究淋巴细胞及其分泌的因子和几种时相蛋白在食管癌患者手术前后的变化及意义。方法采用流式细胞术、酶联免疫吸附法及速率散射比浊法检测食管癌根治术患者手术前后的T细胞亚群和NK细胞,血清中IL6和TNFα,以及C反应蛋白(CRP)、前白蛋白(PAB)、转铁蛋白(TRF)的水平。结果与健康对照组比较,食管癌患者组CD3+CD4+T细胞明显增高(P<0.05),CD3+CD8+T细胞明显减少(P<0.05),二者比例增高(P<0.05),术后较术前更明显(P<0.05);术后NK细胞较术前明显减少(P<0.05);手术前后血清中IL6和TNFα水平与健康对照组比较显著增高(P<0.05);CRP水平显著增高(P<0.05),PAB和TRF水平显著降低(P<0.05),术后较术前更明显(P<0.05)。结论食管癌患者T细胞亚群的平衡紊乱导致其细胞因子合成分泌紊乱,具有B细胞活化刺激和炎症活化刺激效应的IL6和TNFα因子在调节急性时相性反应蛋白的合成过程中起重要作用。当CRP持续升高,负性时相蛋白PAB、TRF水平持续性降低可提示患者预后不良。对恶性肿瘤患者检测血浆中IL6和TNFα可了解其细胞免疫功能状态,而CRP、PAB和TRF同样可作为肿瘤治疗监测和预后判断的参考指标。
Objective To explore the changes and functions of lymphocytes and their cytokines, as well as some acute reaction proteins （ARPs） in patients with esophagus cancer before and after operation. Methods Total of 28 patients with esophagus cancer and 46 healthy controls were analyzed for T cells, NK cells, IL-6, TNF-α, and ARPs （CRP, PAB, TRF）. Results As compared with control, CD3^ ＋ CD4^ ＋ T cells were increased （ P 〈 0.05） but CD3^＋ CD8^ ＋ T cells were decreased （ P 〈 0.05 ）, thus the ratio was increased （ P 〈 0.05） in patients with esophagus cancer, and the trend was more significant after operation （ P 〈 0.05）. NK cells in patients with esophagus cancer were decreased after operation （ P 〈 0.05）. The levels of IL-6 and TNF-α in serum of the patients were increased （ P 〈 0.05） and the level of CRP was increased （ P 〈 0.05）, but the levels of PAB and TRF were decreased （ P 〈 0.05）, and the trend was more significant after operation （ P 〈 0.05）. Coclusion In esophagus cancer patients, the disturbance of T lymphocytes leads to the disturbance of cytokines. More and more IL-6 and TNF-α induce liver cells to synthesize ARPs. Positive ARPs such as CRP is increased, while negative ARPs such as PAB and TRF are decreased. This study helps us to learn about immune pathology of esophagus cancer, interpret the mechanisms, and design treat plan.
出处
《免疫学杂志》
CAS
CSCD
北大核心
2006年第4期419-422,共4页
Immunological Journal
