摘要
目的乳腺癌是女性最常见的恶性肿瘤之一。有研究显示,脾多肽能显著改善肿瘤患者化疗引起的毒副作用和免疫抑制现象。本研究拟通过自身对照实验,探究脾多肽对乳腺癌化疗患者免疫功能的调节作用,为其更广泛的临床应用提供理论依据。方法选取河南大学第一附属医院乳腺外科2018-10-01-2019-05-31收治入院的乳腺癌术后ECT密集方案化疗患者92例作为研究对象,EC阶段和T阶段各46例,收集并分析两组患者未使用脾多肽情况下外周血中T淋巴细胞亚群及自然杀伤细胞(natural killer cell,NK)水平。联合脾多肽治疗2个周期,采用自身用药前后对照,观察各组患者用药前后T淋巴细胞亚群及NK细胞水平变化。同时纳入两组临床资料特征,以治疗前后变化水平差值为因变量,采用多元线性回归分析影响调节差异的主要因素。结果两组患者经脾多肽治疗后,除CD8^+细胞外,CD3^+、CD4^+、NK细胞及CD4^+/CD8^+等指标均有不同程度升高,P<0.05;对于CD8^+细胞,EC组治疗前后差异无统计学意义,t=1.496,P>0.05;而T组则由治疗前(28.67±6.52)下降至治疗后(24.22±6.16),差异具有统计学意义,t=2.994,P<0.05。多元线性回归分析结果显示,肿瘤分期和化疗阶段可能是影响脾多肽对CD8^+细胞调节差异的主要原因,P<0.05。进一步回顾分析两组患者用药前免疫细胞水平发现,EC组中CD4^+/CD8^+比值(1.01±0.35)低于T组(1.29±0.46),且CD8^+细胞水平(34.17±7.34)高于T组(28.67±6.52),具有统计学意义(t=-2.059,P<0.05;t=2.377,P<0.05)。两组CD3^+、CD4^+、NK细胞等指标差异无统计学意义,P>0.05。结论脾多肽可通过提高外周血中CD3^+、CD4^+、NK细胞及CD4^+/CD8^+比值有效改善乳腺癌化疗患者机体的细胞免疫功能,但其对CD8^+细胞调节作用可能受肿瘤分期及患者免疫水平影响,未来尚需要对其具体作用机制进行深入探究。
OBJECTIVE Breast cancer is the most common malignant tumor in women.Some studies have shown that lienal polypeptide can significantly reduce the toxicity and immunosuppression of cancer patients induced by chemotherapy.In this study,we intended to explore the regulatory effect of lienal polypeptide on immune function of breast cancer patients undergoing chemotherapy through self-control experiments,and provide theoretical basis for its wider clinical application.METHODS Ninety-two patients with EC-T intensive regimen after breast cancer surgery in the department of breast surgery of the First Affiliated Hospital of Henan University from October 2018 to May 2019 were collected,including 46 patients in EC stage and 46 patients in T stage.The levels of T lymphocyte subsets and natural killer(NK)cells in peripheral blood were compared between the two groups without the use of lienal polypeptide.Then,the two groups were treated with lienal polypeptide for two courses.The changes of T lymphocyte subsets and NK cells before and after treatment were observed in each group.The difference of cell level before and after treatment was taken as dependent variable,and the main factors affecting the regulation difference were analyzed by multiple linear regression.RESULTS After treatment with lienal polypeptide,the ratios of CD3^+,CD4^+,NK and CD4^+/CD8^+in peripheral blood of the two groups were significant higher than those before treatment(P<0.05).However,there was no significant difference in CD8^+cells before and after treatment in EC group(t=1.496,P>0.05).But the level of CD8^+cells in the T group decreased from(28.67±6.52)before treatment to(24.22±6.16)after treatment,and the difference was statistically significant(t=2.994,P<0.05).Multivariate linear regression analysis showed that tumor stage and chemotherapy stage were the main factors influencing the regulation of lienal polypeptide on CD8^+cells(P<0.05).Further retrospective analysis showed that the ratio of CD4^+/CD8^+in EC group was lower than that in T group(1.
作者
张棕帆
师丙帅
吴海滨
何建鑫
瓮小龙
董玲
吴名一
张双林
ZHANG Zong-fan;SHI Bing-shuai;WU Hai-bin;HE Jian-xin;WENG Xiao-long;DONG Ling;WU Ming-yi;ZHANG Shuang-lin(epartment of Breast Surgery,First Affiliated Hospital of Henan University,Kaifeng 475001,P.R.China)
出处
《中华肿瘤防治杂志》
CAS
北大核心
2019年第21期1627-1631,共5页
Chinese Journal of Cancer Prevention and Treatment
基金
河南大学研究生教育创新与质量提升计划（SYL18060146）
关键词
脾多肽
乳腺癌
T淋巴细胞亚群
免疫功能
lienal polypeptide
breast cancer
T lymphocyte subsets
immunity
