食管癌放疗患者T淋巴细胞和自然杀伤细胞水平的临床研究

 【摘要】　目的　探讨行放疗的食管癌患者外周血T淋巴细胞、自然杀伤（NK）细胞的变化及其与放疗疗效的相关性。方法　对56例经病理组织学确诊的食管癌患者采用单纯放疗，应用流式细胞术测定其治疗前后外周血T淋巴细胞亚群及NK细胞比例，评价其与近、远期治疗效果的相关性。以30名健康体检者外周血为健康对照。结果　食管癌患者外周血T细胞比例、Th细胞比例、Th／Ts分别为（58.3±5.2）%、（28.7±5.0）%、1.0±0.3，低于健康对照组的（65.8±7.2）%、（38.1±7.7）%、1.6±0.7（均P＜0.05）；而Ts细胞比例为（28.8±5.3）%，高于健康对照组的（25.4±5.7）%（P＜0.05）。外周血T淋巴细胞亚群及Th／Ts的变化与患者性别、肿瘤分期、病理分化程度、病变部位等临床病理参数之间的差异均无统计学意义（均P＞0.05）。放疗后，患者外周血总T细胞比例、Th细胞比例、Th／Ts及NK细胞比例分别为（66.9±4.5）%、（40.6±5.6）%、（1.6±0.5）%和（16.2±3.9）%，均高于治疗前的（59.4±4.9）%、（29.1±4.2）%、（1.0±0.4）%和（14.6±3.2）%（均P＜0.05），而Ts细胞比例治疗后为（25.4±3.6）%，较治疗前的（28.4±5.7）%降低（P＜0.05）。总T细胞、Th细胞增高程度与病变进展密切相关，差异有统计学意义（均P＜0.05）。结论　T淋巴细胞亚群、NK细胞可用于行放疗的食管癌患者的免疫监测。检测患者外周血相关指标的表达对评估患者的免疫功能、治疗及预后具有一定的临床意义。

Clinical research on expression levels of T lymphocytes and NK cells in patients with esophageal cancer treated with radiotherapy

Objective To study the relationship between the change of T lymphocyte subsets and NK cells in esophageal cancer patients and radiotherapy effect.Methods The levels of T lymphocyte subsets and NK cells were detected by flow cytometry in 56 cases with histologically confirmed esophageal cancer treated with radiotherapy and contrasted to the healthy people.Results In patients with esophageal cancer,peripheral blood T cells,Th cells,Th / Ts were decreased significantly compared with the control group [(58.3±5.2) ％ vs (65.8±7.2) ％,(28.7±5.0) ％ vs (38.1±7.7) ％,(1.0±0.3) vs (1.6+2.7),all P ＜ 0.05],while the Ts cells were significantly increased [(28.8±5.3) ％ vs (25.4±5.7) ％,P ＜ 0.05].There was no significant difference between peripheral blood T lymphocyte subsets,Th/Ts ratio change and patient age,sex,tumor staging,histological differentiation and pathological lesions.After radiotherapy,the levels of peripheral blood T cells,Th cells,Th/Ts cell ratio and NK cells in esophageal cancer patients were increased [(66.9±4.5) ％ vs (59.4±4.9) ％,(40.6±5.6) ％ vs (29.1±4.2) ％,(1.6+0.5) ％ vs (1.0±0.4) ％,(16.2±3.9) ％ vs (14.6±3.2) ％,all P ＜ 0.05],while the Ts cells decreased [ (25.4±3.6) ％ vs (28.4±5.7) ％,P ＜ 0.05].The increasing degree of peripheral blood T cells,Th cells were closely related to the lesion progress,the difference was significant (both P ＜ 0.05).Conclusion Cellular immune function in patients with esophageal cancer is low.Detection of T lymphocyte subsets,NK cells can be used for immune monitoring of patients with esophageal cancer.