食管癌患者外周血Th1/Th2及细胞因子表达的变化

目的 观察食管癌患者机体免疫状态的变化.方法 采用流式细胞技术检测65例哈族患者T淋巴细胞亚群(Th1、Th2、CD3+、CD4+、CD8+细胞),采用双抗体夹心酶联免疫吸附试验(ELISA)法检测血清中自细胞介素(IL)-2、干扰素(IFN)-γ、IL-4、IL10、sIL-2R和肿瘤坏死因子(TNF)-β水平.结果 食管癌患者外周血Th1/Th2细胞比值降低(P<0.05),其中Th1细胞表达的IL-2、IFN-γ等细胞因子水平低于正常对照组;Th2细胞表达的IL-4、IL10细胞因子水平高于正常对照组(P<0.05).T细胞介导的细胞免疫及血清sIL-2R和TNF-β水平存在改变和紊乱,其程度与肿瘤TNM分期相关,其特征为:CD3+、CD4+细胞减少(P<0.05),而CD8+细胞增加(P<0.01);CD4+/CD8+细胞比值下降(P<0.01),血清sIL-2R和TNF-β水平升高(P<0.05).食管癌根治术后1个月CD3+、CD4+细胞回升,CD8+细胞回降,同时血清sIL-2R和TNF-β水平降低(P<0.01).结论 食管癌患者外周血Th1/Th2细胞比值降低,细胞因子表达失衡,患者存在免疫功能抑制.

Changes In peripheral blood Th1/Th2 and expression of cytokines in Kazukh patients with esophageal cancer

Objective To observe the ehangns in immune state in Kazakh patients with esophage-al squamous cell cancer (ESCC). Methods Flow cytometry was used to examine the subgroups of T lym-phoeytes. ELISA assay was used to determine the serum levels of IL-2, INF-γ, IL-4, IL10, slL-2R and TNF-β. Results Th1/Th2 ratio of peripheral blood was significantly lower in esophageal cancer group (P <0.05). IL-2 and IFN-γ expressed by Th1 were significantly lower than in control group, while IL-4 and IL-10 expressed by Th2 were significantly higher (P < 0.05). T ceil-mediated cellular immunity was disor-dered, and the degree was related to TNM stage. The characteristics were as follows : CD3+ and CD4+ were decreased and CD8+ increased (P < 0.05) ; the Th1/Th2 ratio was significantly decreased (P < 0.05),sIL-2R and TNF-β were increased (P <0.05). One month postoperation, CD3+ and CD4+ were in-creased, CD8+ decreased, and sIL-2R and TNF-β decreased (P < 0.01). Conclusion Dynamic observa-tion and surveillance of ratio of CD4+/CD8+ and serum levels of IL-2, INF-β, IL-4, IL-10, sIL-2R and TNF-β is a sensitive index to judge the immune function,TNM stage ,prognosis ,post-operational effective-ness and early detection of recurrence of Kazakh patients with EC.