鼻咽癌患者微波热疗联合放疗前后T细胞亚群的变化及预后价值

目的 探讨微波热疗联合放疗前后鼻咽癌患者外周血中T细胞亚群的变化及其预后价值。方法 用流式细胞仪检测了20例非癌症患者(对照组)和30例鼻咽癌患者微波热疗联合放疗前后及20例单纯放疗鼻咽癌病人T细胞亚群。结果 与对照组相比,鼻咽癌病人外周血CD3⁺CD4⁺细胞百分率及CD8⁺CD28⁺细胞百分率降低(P<0.01),CD3⁺CD8⁺细胞和CD8⁺CD28⁺细胞百分率明显升高(P<0.01),CD4/CD8比值降低(P<0.01)。微波热疗联合放疗后1个月,病人外周血CD3⁺CD4⁺细胞百分率及CD8⁺CD28⁺细胞百分率进一步降低,CD3⁺CD8⁺细胞和CD8⁺CD28^-细胞百分率继续升高,3个月后上述结果仍进一步恶化,且与病人的存活期限有明显关系。结论 微波热疗联合放疗后病人的T细胞免疫功能在较长时间内是受抑制的。CD8⁺CD28⁺和CD8⁺CD28^-T细胞亚群的检测对微波热疗联合放疗病人的预后有重要临床意义。

Prognostic value of changes of peripheral blood T cell subsets after thermoradiotherapy for nasopharyngeal carcinoma

Objective To assess the prognostic value of changes of peripheral blood T cell subsets after thermoradiotherapy for nasopharyngeal carcinoma (NPC). Methods Peripheral blood T cell subsets in 20 normal subjects (control group), 30 NPC patients undergoing thermoradiotherapy, and 20 NPC patients undergoing radiotherapy were detected by flow cytometry. Results The percentages of CD3~ CD4~ and CD8~ CD28~ cells were decreased and the percentages of CD3~ CD8~ and CD8~ CD28~- cells increased as compared with the measurements in normal persons. One month after thermoradiotherapy, the percentages of CD3~ CD4~ and CD8~ CD28~ cells further decreased and the percentages of CD3~ CD8~ and CD8~ CD28~- cells further increased, which continued to worsen 3 months after the treatment and appeared to be related to the survival of the patients. Conclusion T cell subsets of NPC patients are abnormal and their immune functions depressed in NPC patients within a long period after thermoradio- therapy. CD8~ CD28~ and CD8~ CD28~- T cell subsets can be significant for prognostic assessment in these patients after ther- moradiotherapy.