晚期乳腺癌患者化疗前后血清Th1/Th2细胞因子变化趋势及意义

目的了解晚期乳腺癌患者化疗中Th1/Th2细胞因子的变化趋势,探讨Th1/Th2的变化与化疗近期效果的关系。方法使用流式微阵列术检测乳腺癌患者化疗前1周内、第一疗程第20天、第二疗程第20天、第四疗程第20天Th1(IL-2、TNF、IFN-γ)/Th2(IL-4、IL-6、IL-10)细胞因子的浓度,同时采用RECIST标准评价化疗近期疗效。结果 126例乳腺癌患者化疗有效率为59.52%。化疗有效患者中血清Th1类细胞因子浓度逐渐升高,其中IL-2、TNF的增高程度有统计学意义(P=0.005和0.001)。Th2类细胞因子在化疗过程中均逐渐下降,其中IL-4、IL-6的下降程度有统计学意义(P=0.01和0.001)。化疗无效病例中,血清Th1类细胞因子未见上升趋势。而Th2类细胞因子则随着化疗的进行均呈现升高趋势,其中IL-4、IL-6升高的程度有统计学意义(P=0.001和0.005)。结论晚期乳腺癌患者存在Th1/Th2失衡,无效化疗会促进Th1/Th2失衡,而有效化疗可逆转Th1/Th2失衡。

The tendency and significance of serum Th1/Th2 cytokines during chemotherapy for advanced breast cancer

Objecive To observe the variation of serum Thl/Th2 cytokine in patients with advanced breast cancer dur- ing the chemotherapy, so to explore the relationship between the serum Thl/Th2 cytokine and chemotherapeutic re- sponse. Methods Serum concentrations of Thl （IL-2, TNF, IFN-γ）/Th2 （IL-4, IL-6, IL-10） cytokine were tested one week before chemotherapy and on 20th day of first, second, and fourth cycle of chemotherapy respectively by cytometric bead array. The chemotherapy response was assessed by RECIST. Results Of I26 advanced breast cancer patients, the responsive rate was 59.52%. In responsive cases, the Thl-type cytokine ascended gradually during the course of chemother- apy, and IL-2, TNF increased highly enough to reach the statistical significance,P=0.005 and 0.001 respectively. The Th2-type eytokine descended gradually during the course of chemotherapy, and IL-4 and L-6 decreased lowly enough to reach the statistical significance. In non-responsive cases, the Thl-type cytokines were not increased,whereas the Th2-type cytokine ascended gradually during the course of chemotherapy, and IL-4, IL-6 increased highly enough to reach the statistical significance,P=0.001 and 0.005 respectively. Conclusion Nonreponsive chemotherapy could en- hance imbalance between Th1/Th2, whereas effective chemotherapy could reverse the imbalance between Thl/Th2.