联合检测外周血T淋巴细胞AgNOR活性及T淋巴细胞亚群评估食管癌围手术期细胞免疫变化规律

背景与目的食管癌患者存在着细胞免疫功能抑制,测定T淋巴细胞核仁区的AgNOR活性及T淋巴细胞亚群,可以了解T淋巴细胞的免疫活性状态,对研究肿瘤的生物学行为具有重要意义。本研究旨在通过动态观察食管癌患者围手术期外周血T淋巴细胞AgNOR的活性及T淋巴细胞亚群的变化规律,研究细胞免疫机能状态及手术对食管癌患者细胞免疫功能的影响。方法分别抽取75例健康人外周血和70例食管癌患者术前、术后第3天、术后第9天的外周血,利用KL型肿瘤免疫图像分析系统检测AgNOR活性,流式细胞术分析T淋巴细胞亚群。结果食管癌患者术前AgNOR活性(5.5±0.8)%]明显低于健康人(7.1±0.8)%](P<0.00),CD3 、CD3 CD4 无明显变化(P>0.05),CD4 CD25 、CD4 /CD8 明显上升(P<0.05),CD3 CD8 、CD8 CD25 亚群明显下降(P<0.00)。术后第3天外周血T淋巴细胞AgNOR、CD3 、CD3 CD4 与CD4 /CD8 最低,术后第9天最高;CD3 CD8 亚群、CD4 CD25 亚群、CD8 CD25 亚群则从第3天开始逐渐恢复,术后第9天最高。食管癌患者术后第9天CD3 、CD3 CD4 与健康人相比无显著性差异(P>0.05);外周血T淋巴细胞AgNOR、CD3 CD8 与CD8 CD25 仍未恢复到健康人水平(P<0.05);CD4 CD25 仍明显高于健康人(P<0.00)。结论手术创伤引起食管癌患者暂时性细胞免疫抑制,但从第3天开始可观察到细胞免疫功能恢复,术后第9天继续恢复,但仍未恢复到正常水平。

Perioperative changes of cellular immune response of patients with esophageal carcinoma evaluated through detecting AgNOR content in peripheral blood T lymphocytes and T cell subsets

BACKGROUND & OBJECTIVE: Patients with esophageal carcinoma often have immunosuppression. This study was to detect perioperative argyrophil nucleolar orgnizer region (AgNOR) content in peripheral blood T lymphocytes and T cell subsets of patients with esophageal carcinoma, investigate the influences of cellular immune condition and surgery on cellular immune function of these patients. METHODS: Peripheral blood samples were obtained from 75 healthy adults and 70 patients with esophageal carcinoma before surgery, 3 and 9 days after surgery. AgNOR content in peripheral blood T lymphocytes was measured by tumor immune microphotometry; T cell subsets was measured by flow cytometry. RESULTS: Before operation, AgNOR content, proportions of CD3+CD8+ and CD8+CD25+ T cells were significantly lower in patients than in healthy controls (P < 0.001); proportions of CD3+ and CD3+CD4+ T cells of patients were not significantly different from that of healthy controls (P > 0.05); proportions of CD4+CD25+ and CD4+/CD8+ T cells were significantly higher in patients than in healthy controls (P < 0.05). In peripheral blood T lymphocytes of the patients after operation, AgNOR content, CD3+, CD3+CD4+, and CD4+/CD8+ T cells were the lowest at the 3rd day, and the highest at the 9th day; CD3+CD8+, CD4+CD25+, and CD8+CD25+ T cells gradually ascended from the 3rd day. At the 9th day after operation, CD3+ and CD3+CD4+ T cells of patients were not significantly different from that of healthy controls (P> 0.05); AgNOR content, CD3+CD8+ and CD8+CD25+ T cells were still lower in patients than in healthy controls (P<0.05); CD4+CD25+ and CD4+/CD8+ T cells were still higher in patients than in healthy controls (P<0.001). CONCLUSION: Surgery injure may cause temporary cellular immunosuppression in patients with esophageal carcinoma, which slowly recovers early after operation.