放疗早期对口腔颌面部肿瘤患者免疫功能影响的临床研究

目的 :通过对患者放疗后早期与放疗前的血液,进行免疫细胞检测及外周血基因表达谱芯片检测,分析放疗早期对机体免疫功能的影响。方法:22例口腔颌面肿瘤患者,检测放疗前1周和后1周的血液中,CD3+T、CD4+T、CD8+T、B、NK细胞数量及比例变化。通过表达谱芯片检测筛选放疗前后血液标本的差异基因,用R语言及DAVID数据库行功能分类和信号传导通路相关性分析。结果:患者淋巴细胞及其亚类数目在放疗后明显下降。表达谱芯片筛选出368个免疫炎症相关基因。涉及的信号通路主要是T细胞受体信号通路、黏附分子、NK介导细胞毒效应等相关通路。结论:放疗能部分激活CD8+T及NK细胞介导的杀伤免疫,同时抑制T细胞和NK细胞的分化及其信号传导通路。

Effects of Radiotherapy on the Immune Function in Patients with Oral and Maxillofacial Cancer

Objective: To analyze the early effects of radiotherapy on the immune function of patients with oral and maxillofacial cancer. Method: Detection of blood immune cells and analyze of peripheral blood gene expression profile were performed. The number and percentage of CD3+T, CD4+T, CD8+T, B and NK cells were examined before and after radiotherapy in 22 patients with oral and maxillofacial cancers. The differential expression gene of blood samples before and after radiotherapy was detected by gene microarray. The gene ontology and signal transduction pathway was analyzed based on R project and DAVID database. Results: The number of lymphocytes and subtypes significantly decreased after radiotherapy. The expression profiles of 368 immune and inflammatory genes were selected. The main signaling pathways involved are the receptor signaling pathway of T cells, the adhesion molecules, and the cytotoxic effect of NK cells. Conclusion: The conventional fractioned radiotherapy can activate cell mediated immunity of CD8+T and NK cells, but inhibit the differentiation of T cells and NK cells signaling transduction pathway.