肿瘤病人细胞免疫功能状态及其临床意义

目的：研究肿瘤患者的外周血T淋巴细胞亚群的表达情况及其临床意义。方法：采用流式细胞仪分析172例肿瘤患者和56例正常对照者外周血T细胞亚群表达情况,同时检测肿瘤病人外周血肿瘤标志物CEA水平。结果：肿瘤病人外周血中T淋巴细胞（CD3＋细胞）比例较正常人有减少趋势,但无显著性差异;与正常人相比,CD4＋细胞比例均较正常人降低,其中肺癌组和其它组有显著性差异,并且有Th1向Th2的漂移趋势;CD8＋细胞则有升高趋势,且在肺癌组、胃癌组和其它组存在显著性差异;与正常人组比较各组CD4＋/CD8＋细胞比值明显降低,差异有显著性。肿瘤病人根据CEA水平分组,CEA升高组较CEA正常组CD4＋/CD8＋细胞比值明显降低,差异有显著性。结论：肿瘤患者CD4＋T细胞/CD8＋T细胞比例的降低可能反映了细胞免疫功能的紊乱,T细胞亚群可与肿瘤标志物协同用于了解病人的疾病和免疫状态。

Clinical Significance of Changes of Cellular Immuno-function in Patients with Malignancy

Objective To study the clinical significance of changes of peripheral T cell subsets expression in patients with malignancy.Methods Peripheral T cell subsets expressions were examined with flow-cytometry in 172 patients with different kinds of carcinoma and 50 controls.Serum CEA levels were also determined with CLIA.Results The CD3＋ percentage in the patients was lower than that in the controls but not significantly.CD4＋ percentage in the patients was also lower（significantly in patientts with lung cancer）.On the contrary,the CD8＋ percentage was higher in the patients（significantly in patients with lung and gastric cancer）.The CD4＋/CD8＋ ratio in the patients was significantly lower than that in controls（P0.05）.As a whole,there was tendency of change from Th1 to Th2 in the patients with respect to CEA levels,the CD4＋/CD8＋ ratio in patients with elevated CEA levels was significantly lower than those in patients without elevated CEA levels（P0.05）.Conclusion Lowered CD4＋/CD8＋ ratio in patients with malignancy might reflect disordered immuno-function and might be useful for clinical assessment.