肾细胞癌和膀胱癌患者的T和NK细胞ζ链水平与临床意义

目的 研究肾细胞癌和膀胱癌患者外周血T和NK细胞ζ链水平与肿瘤发展进程的相关性及其临床意义。方法 采用3种荧光标记的抗CD3、CD56和ζ链单抗及流式细胞仪测定58例。肾细胞癌、22例膀胱癌患者及14名健康人外周血T和NK细胞ζ链蛋白的水平。结果 肾细胞癌Ⅰ、Ⅱ、Ⅲ期患者的ζ链水平在T细胞中分别下降到健康对照组的59．5%、37．6％和21．3％;在NK细胞中分别下降到对照组水平的62．2％、27．1％和18．8％。膀胱癌患者ζ链的水平在T细胞中分别下降到对照组的37．6％、29．5％和18．9％;在NK细胞中分别下降到对照组的35．4％、20．8％和5．8％。检测的标本中还有17．5％(14／80)的患者T和NK细胞ζ链水平在正常范围内。Ⅲ期患者外周血中T和NK细胞的比值与健康对照组相比显著下降。结论 肾细胞癌和膀胱癌患者体内T和NK细胞的ζ链水平总体上与肿瘤的发展进程一致。T和NK细胞比值显著下降可能预示患者病情严重,T和NK细胞ζ链水平正常的肿瘤患者可能是免疫治疗的适应证。

Zeta chain level of T and NK cells in patients with renal-cell carcinoma and bladder cancer and its clinical significance

OBJECTIVE: To study the relationship between zeta chain level of peripheral blood T/NK cells and tumor progression in renal-cell carcinoma and bladder cancer and its clinical significance. METHODS: The peripheral blood mononuclcear cells in 58 patients with renal cell carcinoma, 22 patients with bladder cancer and 14 healthy blood donors were examined by flow cytometry with fluorescent anti-CD3 (for T cells), or anti-CD56 (for NK cells) and anti-zeta chain monoclonal antibodies. RESULTS: The zeta chain expression of T cell and NK cell in stage I, II and III renal-cell carcinoma decreased to 59.5%, 37.6%, 21.3% and 62.2%, 27.1%, 18.8% of the healthy control level, respectively. That in stage I, II and III bladder cancer decreased to 37.6%, 29.5%, 18.9% and 35.4%, 20.8%, 5.8% of the control level, respectively. T and NK cell zeta chain levels in 17.5% (14/80) of the patients were within the normal range. T/NK ratios of peripheral blood in stage III patients were remarkably lower than those of the healthy donor. CONCLUSION: Reduced T and NK zeta chain levels and T/NK ratio in the renal-cell carcinoma and bladder cancer are generally consistent with tumor progression. The patients with normal T and NK zeta chain level may be indicated for immunotherapy.