髓源性抑制细胞在胃癌患者外周血中的变化及临床意义

目的: 观察胃癌患者外周血中髓源性抑制细胞（myeloid derived suppressor cells,MDSCs）的数量变化并探讨其临床意义。方法：选取24例胃癌患者和15例健康志愿者,术前收集外周血2 mL；选择术后30天、门诊复诊经检查恢复顺利的患者18例与术前配对，收集外周血, 以CD14 /CD11b+/CD33+/HLA DR 作为MDSCs的表面标志物。用流式细胞仪检测MDSCs所占的比例，分析MDSCs的数量变化情况及其临床意义。同时对MDSCs在外周血中的表达与临床病理因素相关性进行分析。结果：健康对照组外周血MDSCs占（0.226±0.044）%，胃癌患者术前和术后复诊者外周血MDSCs所占比例分别为（1.903±0.247）%，（1.120±0.240）%。胃癌患者与对照组MDSCs比例差异有统计学意义（t=2.47，P<0.05）,手术前后MDSCs差异有统计学意义（t=2.14，P<0.05）。MDSCs在胃癌患者外周血的表达与性别、年龄、肿瘤大小、浸润深度、TNM分期以及有无淋巴结转移无关,与肿瘤的分化程度相关。 结论： MDSCs在胃癌患者免疫功能障碍中起重要作用，肿瘤负荷减轻后机体抗肿瘤免疫功能有所恢复。

Quantity change and clinical significance of myeloid-derived suppressor cells in peripheral blood of the patients with gastric cancer

Objective： To explore the quantity change and significance of myeloid-derived suppressor cells（MDSCs） in peripheral blood of the patients with gastric cancer.Methods ： Twenty-four patients with gastric cancer were enrolled in this study,collected preoperative peripheral blood 2 mL.And fifteen healthy volunteers were done so too.Selected patients 30 days after operation and restored smoothly 18 cases to be checked,and matched with preoperative data.Collected the peripheral blood and the factors of CD14-/ CD11b＋/ CD33＋/ HLA-DR-were taken as marks of MDSCs.Analysed the changes of MDSCs number and clinical significance of the proportion using flow cytometry（FCM）.At the same time,analyzed the relationship between the expression of MDSCs in peripheral blood and clinical pathological factors.Results： MDSCs in peripheral blood of healthy controls accounted for（0.226 ± 0.044） %,MDSCs proportion of gastric cancer patients with preoperative and postoperative checking in peripheral blood were（1.903 ± 0.247） % and（1.120 ± 0.240） % respectively.The MDSCs proportion difference in gastric cancer pantients and control group was statistically significant（P 0.05）,and the MDSCs proportion before and after surgery had significant difference too.MDSCs in the peripheral blood of patients with gastric cancer associated with the degree of tumor differentiation,had nothing to do with gender,age,tumor size,depth of invasion,TNM staging and with or without lymph node metastasis.Conclusions： MDSCs play an important role in gastric cancer patients with immune dysfunction.The body＇s anti-tumor immune function had been some restored after cutting down tumor burden.