肺肿瘤患者围手术期CD28及T细胞亚群检测的临床意义

目的:检测肺肿瘤患者手术前后外周血CD28和T淋巴细胞亚群的表达变化并探讨其意义。方法:采用流式细胞术检测63例肺肿瘤患者手术前后外周血CD28及T淋巴细胞亚群的表达,并与健康对照组及肺良性肿瘤组作比较。结果:肺肿瘤组术前外周血中CD3+、CD4+、CD4+/CD8+、CD8+CD28+水平明显低于健康对照组和肺良性肿瘤组,而CD8+水平明显升高。肺肿瘤组CD8+表达水平随着临床分期的进展而有显著升高,CD3+、CD4+、CD4+/CD8+和CD8+CD28+水平随着临床分期的进展而有显著降低。不同病理分型的肺肿瘤患者之间外周血CD28及T细胞亚群水平无明显差异。肺肿瘤患者术后CD3+、CD4+、CD4+/CD8+和CD8+CD28+表达显著升高;CD8+的表达明显降低,但仍未恢复至健康水平。结论:肺肿瘤患者CD3+、CD4+、CD4+/CD8+和CD8+CD28+表达水平低下,从而影响B7-CD28共刺激通路,使T细胞不能有效的清除肿瘤,提示肺肿瘤患者机体免疫功能低下,施行手术切除肿瘤有助于改善患者的细胞免疫功能。

Detection of CD28 and T lymphocyte subset in perioperative period of patients with lung cancer

Objective：To investigate the changes of CD28 and T lymphocyte subset in the peripheral blood from patients with lung cancer undergone modified radical operations and its significance. Method.. The expression of CD28 and T lymphocyte subset on the peripheral blood lymphocytes （PBLC） was measured by flow cytometric assay in 63 patients with lung cancer, and the data were compared and analyzed with that in normal control and lung benign tumor group. Result：Expression of CD3＋ ,CD4＋ ,CD4＋/CD8＋ and CD8＋ CD28＋ on PBLC in patients with lung cancer was significantly lower before operation than that of normal control and lung benign tumor group. The proportion of CD8＋ of the patients with lung cancer was remarkably higher before operation than that of the control group. The expression of CD8＋ of lung cancer group were Correlated significantly with the progress of clinical and has significantly increased. The expression of CD3＋ , CD4＋ , CD4＋/CD8＋ and CD8＋ CD28＋ of lung cancer group were correlated significantly with the progress of clinical and has decreased significantly. No significant differences between different pathological types of lung cancer patients in peripheral blood CD28 and T lymphocytes subsets. The expression of CD3＋ , CD4＋ , CD4＋/CD8＋ and CD8＋ CD28＋ was significantly increased in patients with lung cancer after operation. The expression of CD8＋ was decreased, but has not been restored to health. Conclusion.. The facts that low level of CD3＋ , CD4＋ , CD4＋/CD8＋ and CD8＋ CD28＋ of peripheral blood from lung cancer patients may influence the B7-CD28 costimulatory pathway, resulting in the failure of T lymphocytes to eliminate tumor cells effectively. Removal of the tumor may be benefit to improve the cellular immunity of the patients.