不同级别脑胶质瘤患者手术前后外周血T淋巴细胞免疫细胞水平变化及意义

目的：探讨不同级别脑胶质瘤患者手术前、后外周血 T 淋巴细胞免疫细胞水平变化及临床意义。方法选择2010年2月至2012年2月该院收治的80例颅脑肿瘤患者作为研究对象，其中胶质瘤57例，其他肿瘤23例；胶质瘤按照 WHO 分级标准分为低级别组19例和高级别组38例，另选择同期在该院体检的健康人群50例作为对照组。抽取对照组、其他颅脑肿瘤组和胶质瘤组术前1 d 、术后1周静脉血，检测外周血 T 淋巴细胞亚群水平，并分析不同级别脑胶质瘤与预后的关系。结果对照组外周血 CD3＋、CD4＋、CD4＋／CD8＋显著高于其他颅脑肿瘤组和胶质瘤组，CD8＋显著低于其他颅脑肿瘤组和胶质瘤组，差异均有统计学意义（P＜0．05）；与其他颅内肿瘤组比较，胶质瘤组外周血 CD3＋、CD4＋、CD4＋／CD8＋显著降低，CD8＋显著升高，两组间差异有统计学意义（P ＜0．05）；手术前、后低级别组 CD3＋、CD4＋／CD8＋均显著高于高级别组，CD8＋显著低于高级别组（P＜0．05）；组内比较，两组患者术后1周 CD3＋、CD4＋／CD8＋升高，CD8＋显著降低（P＜0．05）。低级别组中位生存期31个月，高级别组中位生存期13个月，两组间差异有统计学意义（P＜0．05）；CD4＋／CD8＋＞1组中位生存期为34个月，CD4＋／CD8＋＜1组中位生存期为17个月，两组比较差异有统计学意义（P＜0．05）。结论脑胶质瘤患者免疫功能受到抑制，肿瘤恶性程度越高，免疫抑制作用越明显；T 淋巴亚群水平检测可以作为脑胶质瘤恶性程度及预后的评价指标之一。

Peripheral blood T lymphocytes cell level of different grades of cerebral gliomas patients before and after operation and its clinical significance

Objective To explore the peripheral blood T lymphocytes cell level in different grades of cerebral gliomas pa-tients at the time of before and after operation and its clinical significance .Methods A total of 80 cases of brain tumor patients from February 2010 to February 2012 in this hospital were chosed as study objects ,included 57 cases of glioma ,23 cases of other brain tumors ;57 cases of glioma were divided into 19 cases of low grade group and 38 cases of high grade group accorded to WHO grading standards ,and 50 cases of healthy people in same period were selected as control group .Venous blood in three groups were extracted at 1st day and 1st week after operation ,to detected the level of T lymphocyte subsets in peripheral blood and analyze the relationship between the different grade gliomas and prognosis .Results The peripheral blood CD3 + ,CD4 + ,CD4 + /CD8 + in control group were significantly higher than that of other brain tumor group and the glioma group ,CD8 + was significantly lower than that of the two groups(P< 0 .05) .Compared with other tumor group ,peripheral blood CD3 + ,CD4 + ,CD4 + /CD8 + in glioma group de-creased significantly ,CD8 + increased significantly(P< 0 .05) ;before and after the operation ,the CD3 + and CD4 + /CD8 + levels were significantly higher in low grade group than in the high grade group ,CD8 + was significantly lower in low grade group than in the high grade group(P< 0 .05) ,at the time of 1st week after operation ,CD3 + and CD4 + /CD8 + increased ,CD8 + decreased significant-ly of two groups when intra-group comparison (P < 0 .05) .The median survival time were 31 months in low grade group and 13 months in high grade group ,and the singnificance was found in two groups(P< 0 .05) .The median survival time were 34 months in CD4 + /CD8 + > 1 group and 17 months in CD4 + /CD8 + < 1 group ,the singnificance was found in two groups(P< 0 .05) .Conclusion The immune function of patients with brain glioma is inhibited ,the higher the malignancy of the tumor ,the more obvious of im-mune inhibition ;T lymphocyte subsets level could be used as evaluating index of malignant degree and prognosis of brain glioma .