原发性肝细胞癌微环境中CD4^＋CD25^＋调节性T细胞分布与局部免疫的关系

目的通过检测原发性肝细胞癌（hepatocellular carcinoma,HCC）局部肝癌组织和癌旁组织中T细胞亚群的分布情况,探讨在肝癌发生、发展过程中CD4^＋CD25^＋调节性T细胞与局部免疫状态的关系。方法54例肝癌组织和癌旁组织及10例正常肝组织用免疫组织化学S—P法标记CD4^＋T细胞、CD8^＋T细胞及CD4^＋CD25^＋调节性T细胞（CD4^＋CD25^＋Tr细胞）,并对组织中CD4^＋CD25^＋Tr细胞与CD4^＋T、CD8^＋T及CD4^＋T／CD8^＋T值进行相关性分析。结果54例肝癌、癌旁组织中CD4^＋CD25^＋Tr细胞单个高倍视野平均数分别为5．6208±2．7235和3．8554±1．6018（P=0．001）;肝癌中CD4^＋CD25^＋Tr细胞数目与肿瘤大小、有无子灶有关,组间差异有显著性（P〈0．01）;肝癌中CD4^＋CD25^＋Tr数量与CD4^＋T细胞的数量以及CD4^＋T／CD8^＋T值呈显著负相关（r=-0．459,P=0．015;r=-0．563,P=0．011）,而与浸润性CD8^＋T细胞的数量分布无关（r=-0．485,P=0．072）。结论在肝癌微环境中CD4^＋T淋巴细胞表达降低,CD4^＋CD25^＋Tr细胞表达增高,后者可能通过抑制CD4^＋T淋巴细胞的增殖来抑制肝癌局部免疫,从而促进肿瘤的进展以及侵袭或转移。     

肝癌荷瘤小鼠调节性T细胞数量的改变及其与肿瘤生长的关系

目的研究肝癌荷瘤小鼠调节性T细胞数量的改变及其与肿瘤生长的关系。方法采用小鼠肝癌细胞系H22接种BALB／c小鼠,建立肝癌模型;采用流式细胞术方法检测CD4^＋ CD25^＋T／CD4^＋T细胞的比例;以RT-PCR和流式细胞术检测Foxp3基因的表达。以免疫磁珠分选法纯化CD4^＋CD25^＋T和CD4^＋CD25^-T细胞;在体外,用3H-TdR掺入法检测T细胞的增殖情况;在体内,观察荷瘤小鼠来源的CD4^＋CD25^＋T细胞对肿瘤生长的作用。结果（1）荷瘤小鼠在引流淋巴结中,CD4^＋CD25^＋T细胞占CD4＋T细胞（18．80％±0．06％）比例增高,与对照组（9．50％±0．03％）相比,差异有统计学意义（P〈0．01）;在非引流淋巴结（LN）和脾脏（SP）中,荷瘤小鼠CD4^＋CD25^＋T／CD4^＋T比例分别为16．28％±0．02％和17．28％±0．06％,与对照组9．50％±0．03％和11．08％±0．04％相比,差异有统计学意义（P〈0．01,P〈0．05）;同时,调节性T细胞特异性标志Foxp3 mRNA的表达也升高。在同一只荷瘤小鼠中,引流淋巴结中CD4^＋CD25^＋T细胞数量（18．8％±0．06％）较对侧非引流淋巴结（16．28％±0．02％）略有升高,但差异无统计学意义（P〉0．05）。（2）从荷瘤小鼠中纯化的CD4^＋CD25^＋T细胞,在体外对抗CD3单抗的刺激无反应,但能抑制CD4^＋CD25^-T细胞的增殖。（3）CD4^＋CD25^＋T／CD4＋T比例与肿瘤大小呈正相关,并且可以抑制CD4^＋CD25^-T细胞的抗肿瘤效应。结论肝癌细胞在小鼠体内的生长可以提高调节性T细胞的数量,其数量的高低与肿瘤的大小呈正相关,提示清除调节性T细胞将是肿瘤免疫治疗的策略之一。     

CD4^＋IL-9^＋细胞在大肠癌免疫微环境中的分布及临床意义

目的：检测CD4^＋IL-9^＋（Th9）细胞在大肠癌免疫微环境中的表型和分布特征,分析其与临床病理的相关性。方法：选取2013-06-05-2013-10-10广西医科大学第一附属医院初次行手术治疗的45例大肠癌患者的肿瘤组织、相对应癌旁组织以及外周血（术前和术后）,同时抽取15例健康志愿者外周血,用流式细胞仪检测各标本中Th9、Th1和Th2在CD4＋细胞中的比例,记录患者的临床病理资料（性别、年龄、民族、Ducks分期、肿瘤大小、淋巴结转移、CEA和AFP水平）;另选取5例同期肠癌患者的肿瘤组织对Th9细胞表型特征（CD45RO／CD45RA）进行流式细胞仪测定。结果：肠癌组织中的Th9细胞比例为（1．12_＋0．33）％,明显高于癌旁组织（0．85±0．29）％和术前外周血（0．65±0．27）％,P值均〈0．05;肠癌组织中Th9细胞表面高表达CD45RO蛋白为（85．23±5．91）％,低表达CD45RA蛋白为（18．23±6．78）％;术前外周血Th9细胞比例为（0．65±0．27）％,明显高于术后外周血（0．47±0．24）％,P=0．0012;Th9细胞与肠癌临床病理相关性分析表明,其与Ducks分期有关,P〈0．05,与其他因素无关;肠癌组织中Th9细胞比例与Th1细胞无明显相关,r=0．140,P=0．360,与Th2细胞比例呈负相关,r=-0．65,P〈0．001。结论：Th9淋巴细胞在大肠肿瘤微坏境存在聚集现象,其与肿瘤的进展有关,可能参与了大肠癌免疫微环境的调节进而影响了肿瘤的发生和发展。     

结肠癌患者外周血淋巴细胞CD8和CD28的表达

[目的]探讨结肠癌患者外周血淋巴细胞CD8、CD28的表达及其临床意义。[方法]用流式细胞术对51例结肠癌患者和30例健康体检者外周血淋巴细胞CD8及CD28进行了检测。[结果]结肠癌组CD8^＋ CD28^-细胞与对照组比较明显增高（P〈0．05），CD8^＋ CD28^＋细胞明显低于健康对照组（P〈0．01）。结肠癌患者手术后CD8^＋ CD28^-细胞与手术前比较明显减低（P〈0．01），手术后CD8^＋ CD28^＋细胞与手术前比较明显增高（P〈0．05）。结肠癌患者淋巴结转移组CD8^＋ D28^＋细胞明显低于未转移组（P〈0．01）。Dukes’C期结肠癌患者CD8^＋ CD28^-细胞与Dukes’A期和Dukes’B期相比明显增高（分别P〈0．01，P〈0．05），随着临床分期的进程，CD8^＋ CD28^＋细胞、CD8^- CD28^＋细胞逐渐减低（分别P〈0．01．P〈0．05）。[结论]检测结肠癌患者的外周血中的CD8 和CD28的表达，对了，解患者的免症状况，疾病进展和指导临床对患者进行免疫调节治疗方面有一定的价值。     

肿瘤患者CD4^＋CD25^＋调节性T细胞流式细胞术分析

目的：分析比较肿瘤患者和健康人外周血CD4^＋CD25^＋调节性T细胞的特点,为肿瘤免疫学研究及治疗探索新方法。方法：收集并分离30例肿瘤患者和32例健康人的外周血单个核细胞（PBMCs）,用荧光标记的抗人CD4及抗人CD25单抗标记肿瘤患者和健康人PBMCs细胞,FCM检测CD4^＋CD25^＋Treg细胞,分析CD4^＋CD25^＋Treg细胞在肿瘤患者和健康人中的差别。结果：肿瘤患者的CD4^＋CD25^＋Treg细胞百分数明显高于健康人（年龄〈55者62．4vs40．4;年龄≥55者53．1vs31．0,P〈0．05）。结论：肿瘤患者的CD4^＋CD25^＋Treg细胞高于健康对照,为肿瘤免疫治疗提供新策略,通过删除CD4^＋CD25^＋Treg细胞,有可能增强抗瘤免疫反应。     

肝癌微环境中CD4+CD25+Treg细胞与肿瘤免疫细胞的关系

[目的]探讨肝癌微环境中Treg细胞的数量增多与HCC临床分期晚的可能原因。[方法]双重酶标免疫组织化学方法检测52例HCC组织中CD4^＋CD25＋Treg细胞以及CD4^＋CD25-T（CD4^＋T）细胞分布，免疫组化EnVision法检测20例HCC组织中CD8＋T细胞分布。[结果]正常肝脏组织中未发现Treg细胞。HCC组织中Treg细胞数量较癌旁组织明显增多（P=0．000），且肝癌组织中Treg细胞的数量与其浸润性CD4＋T淋巴细胞的数量以及CD4＋T/CD8^＋T比值呈显著负相关（r=-0．539，P=0．014；r=-0．545，P=0．000），而与浸润性CD8^＋T淋巴细胞的数量无明显相关性（f=-0．403，P=0．078）。[结论]Treg细胞在体内可能通过细胞接触的方式抑制CD8^＋T淋巴细胞的增殖来抑制肿瘤局部的免疫，去除或减少HCC微环境中浸润件Tree细胞数量可能提高肿瘤局部免疫治疗效果。     

乳腺浸润性微乳头状癌中CD44^＋／CD24^-／low和CD24^＋表型细胞的研究

目的研究乳腺浸润性微乳头状癌（invasive micropapillary carcinoma,IMPC）的干细胞表型,从干细胞和上皮间质转化（epithelial—mesenchymal transition,EMT）角度探讨IMPC高侵袭、高转移恶性生物学行为的原因。方法选取术前未经放化疗治疗患者的IMPC82例和乳腺非特殊型浸润性导管癌（invasive ductal carcinoma not otherwise specified,IDC—NOS）80例石蜡包埋组织标本切片,通过免疫组织化学双染技术检测两组肿瘤组织中CD44^＋／CD24^-/low（CD24^-）和CD24^＋的表达、定位和分布情况,并分析其与各临床病理学特征之间的关系。定量资料采用Student’s t检验,定性资料采用Mann-Whitney U检验、Kruskal—Waliis检验、x^2检验或校正x^2检验。两组之间相关性采用Spearman＇s秩相关分析。结果（1）IMPC组肿瘤细胞的CD44^＋／CD24^-/low阳性表达率（48．8％,40／82例）,明显高于IDC—NOS组（31．3％,25／80例）（x^2=5．180,P=0．023）。（2）53．7％（44／82例）的IMPC微细间质组织内见单个散在的CD44^＋／CD24^-/low肿瘤细胞,且该细胞免疫组织化学染色Vimentin及α—SMA阳性,E—Cadherin阴性。IDC—NOS间质内罕见CD44^＋／CD24^-/low肿瘤细胞。（3）IMPC微乳头结构中CD44^＋／CD24^-/low与间质内的CD44^＋／CD24^-/low阳性表达细胞呈明显正相关（r=0．516,P〈0．001）,并且IMPC微乳头结构及间质中CD44^＋／CD24^-/low阳性表达在有无淋巴管侵犯和有无淋巴结外软组织浸润方面的差异均有统计学意义（P〈0．050）,即有淋巴管侵犯及淋巴结外软组织浸润者CD44^＋／CD24^-/low阳性表达率较高。（4）IMPC组中CD24^＋细胞阳性表达率79．3％（65／82例）,明显高于IDC-NOS组（60．0％,48／80例）（x^2=7．126,P=0．008）,且IMPC中淋巴结转移阳性组CD24的表达高于阴性组,差异有统计学意义（x^2=8．834,P=0．003）。结论IMPC肿瘤细胞中干细胞     

乳腺癌患者淋巴结CD4＋CD25＋T细胞和相关细胞因子的检测及相关性分析

目的探讨CD4＋CD25＋T细胞在乳腺癌发生、发展中的作用。方法将取自35例乳腺癌患者的105个肿大淋巴结,制备成单细胞悬液,应用流式细胞仪检测CD4＋CD25＋T细胞比例及CD4＋CD25-、CD8＋T细胞、NK细胞的相对水平。采用定量RT-PCR法,检测IL-2、IL-10、TGF-β1和IFN-γ的细胞因子水平。结果乳腺癌患者淋巴结中的CD4＋CD25＋T细胞水平（在CD4＋T细胞中的百分含量）与淋巴结转移相关,转移淋巴结中其水平明显高于未转移淋巴结。乳腺癌患者淋巴结中CD4＋CD25＋T细胞与CD4＋CD25-、CD8＋T细胞和NK细胞的水平呈负相关关系。乳腺癌患者淋巴结中CD4＋CD25＋T细胞水平与TGF-β1呈正相关,与IL-2、IL-10、IFN-γ无相关性。乳腺癌患者淋巴结中TGF-β1、IL-10、IFN-γ水平与淋巴结转移相关,转移淋巴结中TGF-β1、IL-10含量高而IFN-γ含量较低。IL-2与淋巴结转移无相关性。结论乳腺癌患者转移淋巴结中的CD4＋CD25＋T细胞水平高于未转移淋巴结。     

HepA-H和HepA-L肝癌荷瘤小鼠CD8+/CD28+T细胞和肿瘤新生淋巴管的研究

目的研究不同淋巴转移潜能肝癌（HepA-H和HepA-L）荷瘤小鼠体内CD8^＋／CD28^＋T淋巴细胞和肿瘤新生淋巴管，探讨与肿瘤淋巴转移的关系。方法用两种来源相同，而淋巴转移能力不同的小鼠肝癌细胞亚系，HepA-H（高淋巴转移）和HepA-L（低淋巴转移），小鼠皮下接种，制备荷瘤动物模型。采用抗小鼠CD8、CD28荧光标记单克隆抗体，流式细胞术定量检测小鼠外周血和肿瘤组织内CD8^＋／CD28^＋T淋巴细胞数量；应用5＇-核苷酸酶-碱性磷酸酶双重组化染色法，观察肿瘤新生淋巴管。结果肿瘤皮下接种后14天，HepA-H组荷瘤小鼠外周血CD8^＋／CD28^＋T淋巴细胞数量明显低于正常对照组（P〈0．05）HepA-H组肿瘤组织内CD8^＋／CD28^＋T淋巴细胞数量显著低于HepA-L组（P〈0．05）。两种肿瘤细胞亚系均可诱导肿瘤新生淋巴管，但HepA-H肿瘤内和瘤周最高淋巴管密度均明显高于HepA-L组（P〈0．01）。结论肿瘤淋巴转移能力的差异与体内CD8^＋／CD28^＋T淋巴细胞数量及肿瘤新新生淋巴管有关。     

CD4+T细胞在抗肿瘤过继性免疫治疗中作用的研究

目的：观察CIK细胞中CD4^＋T细胞中Th1／Th2亚群分布情况。方法：体外大规模扩增CIK细胞，磁珠法纯化其中CD4^＋T细胞．采用胞内染色、ELISA和荧光定量RT—PCR法检测培养前后Th1／Th2细胞亚群的比例、Th1／Th2类细胞因子的分泌量和基因表达的变化。结果：富集CD4^＋细胞纯度达96％，CIK中Th1亚群和Th0亚群的比例较PBMC显著升高（P〈0．05），而Th2亚群无显著变化。CD4^＋CIK细胞中IL-2和IFN-γ等Th1类细胞因子释放量增高（P〈0．01），而IL－10和TGF-β等Th2类细胞因子释放量降低（P〈0．05）。但CD4^＋CIK细胞中除IFN-γ／的mRNA显著升高外（P〈0．05）．IL-2和IL-4的mRNA变化不明显。结论：CIK细胞中的CD4^＋T细胞具有明显的Th1优势。     

Enhanced myeloid specificity of CD117 compared with CD13 and CD33

The c-kit proto-oncogene encodes a 145 kd tyrosine kinase transmembrane receptor, which plays a key role in haemopoiesis. The c-kit has been classified as CD117 and is especially useful in the differential diagnosis of acute myelogenous leukemia (AML) and acute lymphoblastic leukemia (ALL). We analysed 104 consecutive cases (55 AML, 23 B-cell lineage ALL, three T-cell ALL, 11 blast crisis of chronic myeloproliferative disorders and 12 cases of myelodysplastic syndromes with more than 10% of blasts) referred to our Hospital for immunophenotypic diagnosis and compared the expression pattern of CD13, CD33 and CD117 using the same fluorochrome (phycoerythrin-PE). The recommendations of the EGIL group were followed in order to establish lineage involvement of the blastic population. The threshold used to assign positivity for CD117 was 10%. Bcr/abl, TEL/AML-1 and MLL rearrangements were assessed by molecular methods. CD117 expression was detected in 91% of AML and MDS. All the negative cases corresponded to acute monocytic leukemias. The calculated specificity for myeloid involvement was 0.86 for CD117, 0.36 for CD13 and 0.44 for CD33 (P < 0.005). CD117 was also positive in four cases of ALL. None of these cases showed bcr/abl or MLL rearrangements. In the light of these findings, CD117 expression should yield a higher score, at least one point, in the system currently applied for the diagnosis of biphenotypic acute leukemias (BAL) as its myeloid specificity is greater than that of CD13 and CD33. Moreover, its absence in AML could identify two subgroups of M5b cases. The coexpression of CD117 with cytoplasmic CD79a is often associated with CD7 reactivity, suggesting a stem cell disorder. CD117 should be included on a routine basis for the immunophenotypic diagnosis of acute leukemias.     

CD46 CD55 CD59在结肠癌组织中的表达及意义

目的:检测CD46、CD55、CD59在结肠癌组织中的表达情况,分析其与结肠癌临床病理参数间的相关性及意义。方法:选取有详细性别、年龄、组织分化、病理分期、肿瘤部位、组织类型资料的组织芯片标本,包括121 例结肠癌和121 例癌旁结肠组织,均为2004年10月至2006年6 月第四军医大学西京消化病医院胃肠外科手术切除标本。应用免疫组织化学改良二步法分别检测CD46、CD55、CD59的表达情况。结果:CD46、CD55及CD59在结肠癌组织中的阳性表达率均显著高于对应的癌旁组织（P < 0.001）。 CD46表达水平与性别、年龄、组织分化、TNM 病理分期、肿瘤位置、病理组织类型均无关（P > 0.05）。 CD55、CD59的表达水平与性别、年龄、肿瘤位置、病理类型无关（P > 0.05）,而与组织分化、TNM 病理分期有关（P < 0.05）。 其表达强度阳性率中低分化组明显高于高分化组（P < 0.05）。 TNM 分期中Ⅲ、Ⅳ期患者肿瘤病理组织强阳性表达率高于Ⅰ、Ⅱ期阳性表达率,两者比较有统计学意义（P < 0.05）。 结论:CD46、CD55及CD59在结肠癌组织中高表达,特别是CD55、CD59的表达与肿瘤分化、病理分期相关,提示三者表达水平与结肠癌生物学行为密切相关。      

Poor prognosis of mediastinal non-Hodgkin's lymphoma with an immature phenotype of CD2+, CD7 (or CD5)+, CD3-, CD4-, and CD8-

Nine children with mediastinal non-Hodgkin's lymphoma (NHL) were treated according to our new regimen which is characterized by intensified therapy with high-dose cytosine arabinoside (HDCA). After induction therapy with a combination of five drugs, such as vincristine, doxorubicin, cyclophosphamide, 1-asparaginase, and prednisolone, intermediate dosages of methotrexate (MTX) (1 g/m2) and HDCA (1.5 g/m2 x 12 doses) were administered. All but one patient (88.9%) achieved complete remission and then received this intensified therapy. With a median follow-up period of 25.5 months, five patients are still in complete remission, but three patients have relapsed. From the phenotypic point of view, these relapsed patients showed only very immature T-cell differentiation antigens such as CD2 and CD7 (or CD5). These results suggest that HDCA as intensified therapy for children with mediastinal NHL seems to be effective. However, for patients with an immature phenotype of T-lineage cells, more sophisticated regimens should be prepared.     

CD5, CD10, and CD23 expression in Waldenstrom's macroglobulinemia

CD5, CD10, and CD23 are cell surface antigens used to distinguish B-cell disorders. The expression of these antigens and their clinical significance in Waldenstrom's macroglobulinemia (WM), an uncommon B-cell disorder, remains to be clarified. We therefore determined expression of CD5, CD10, and CD23 by flow cytometric analysis on bone marrow lymphoplasmacytic cells (CD19+ k/l light chain restricted) for 171 serially biopsied patients with findings of the consensus panel definition of WM. Importantly, we also correlated laboratory and clinical data, as well as existence of a familial history of a B-cell disorder in view of reports suggesting familial predisposition in WM. These studies demonstrated tumor cell expression of CD5, CD10, and CD23 in 15 of 171 patients (9%), 11 of 161 patients (7%), and 37 of 105 patients (35%), respectively. Coexpression of CD23 with CD5 or CD10 was common. Tumor Lymphoplasmacytic from 10 of 15 (66%) and 3 of 11 (27%) patients with WM that expressed CD5 and CD10, respectively, also showed expression of CD23 (P = 0.01 and P = 0.08, respectively). Among patients with CD23 expression, increased serum immunoglobulin (Ig) M levels were observed compared with patients without CD23 expression (P = 0.05). No differences in age at diagnosis; presence of adenopathy and/or splenomegaly; bone marrow involvement; serum IgA, IgB, and b2 macroglobulin levels; hematocrit; platelet count; or familial history of WM or a related B-cell disorder were observed among patients with and without CD5, CD10, and CD23 expression. These studies demonstrate that CD5, CD10, and CD23 are commonly found in WM and that their expression should not exclude the diagnosis of WM. Moreover, expression of CD23 may define a clinically distinct subset of patients with WM.     

经典型霍奇金淋巴瘤CD15及CD30蛋白表达的研究

目的：探讨CD15和CD30在经典型霍奇金淋巴瘤（cHL)H/RS细胞的表达及区别。方法：采用SABC法对32例cHL中CD15和CD30蛋白的表达进行检测。结果：CD15阳性25例,阳性率为78．1％,CD30阳性30例,阳性率为93．8％,各型之间阳性表达没有显著性差异,2例蛋白表达之间也无显著性差异。结论：CD15和CD30均可作为cHL的诊断免疫标记。     

人CD46、CD55和CD59与肿瘤免疫逃逸及免疫治疗

膜结合补体调节蛋白CD46、CD55和CD59在肿瘤细胞膜上表达或过表达,保护肿瘤细胞免受免疫系统的攻击,成为肿瘤细胞免疫逃逸的途径之一.如何下调肿瘤细胞表面三者表达或抑制其功能以增强其对补体依赖的细胞毒作用的敏感性备受关注.     

A child case of CD34, CD33, HLA-DR, CD7, CD56 stem cell leukemia with thymic involvement

It has been reported that the CD56⁺/CD7⁺/CD3⁻ phenotype of natural killer (NK) cells develop from the CD34⁺/HLA-DR⁻ bone marrow (BM) mononuclear cell population in long-term BM culture (LTBMC). An HLA-DR⁻/CD33⁺/CD56⁺/CD16⁻ myeloid/natural killer cell acute leukemia has been described. We report here a 7-year-old boy who developed stem cell acute leukemia with superior vena cava syndrome secondary to thymic involvement. Surface marker analyses revealed that the leukemia cells showed CD34⁺/HLA-DR⁻/CD33⁻/CD7⁺/CD56⁺ phenotype. When stimulated with phorbol ester in vitro the leukemic cells morphologically differentiated to myeloid cells developing CD13, CD15 and CD56 antigens. Our results suggest that CD34⁺/HLA-DR⁻/CD7⁺/CD56⁺ stem cell leukemia may arise from transformation of a pluripotent precursor cell, which could differentiate to both myeloid and NK cell lineages.