Th1/Th2类细胞因子与葡萄胎恶变的相关性研究

目的:通过对妊娠滋养细胞疾病患者外周血血清中Th1/Th2类细胞因子的测定,从免疫学角度探讨Th1/Th2类细胞因子预测葡萄胎恶变的价值。方法:收集1997至2001年首次以葡萄胎诊断进行清宫和手术的患者的外周血血清,采用酶联免疫吸附法检测血清中IFN-γ、IL-2、IL-4、IL-10的水平来确定Th1/Th2的活性。结果:与侵葡+绒癌组相比,葡萄胎组IFN-γ含量明显增加(P<0.001),IL-10含量明显降低(P<0.001)。葡萄胎患者中,与非恶变组相比,恶变组Th1类细胞因子(IFN-γ,IL-2)含量呈下降趋势,而Th2类细胞因子(IL-4,IL-10)含量呈增加趋势,4种细胞因子变化均具有统计学差异(P<0.0001)。随着滋养细胞增生程度的增加,4种细胞因子的变化均具有统计学差异,除外IL-4的变化在轻、中度增生组中无统计学意义(P>0.05)。结论:Th1/Th2细胞因子向Th2漂移时,葡萄胎恶变倾向增高。

A study of helper T1 cell/helper T2 cell cytokines in the development of post hydatidiform molar tumor

Objective:To investigate the function of Th1(T help type 1)(IFN-γ,IL-2) and Th2(T help type2)(IL-4,IL-10) cytokine in gestational trophoblastic diseases and their significance in the transformation of hydatidiform mole.Methods:The serum samples were obtained from patients who first diagnosed as hydatidiform mole and underwent uterine curettage or operation from 1997 to 2001.The concentrations of serum cytokines(IFN-γ,IL-2,IL-4,IL-10) were measured by sandwich ELISA method to assure the activity of Th1/Th2 cytokine.Results:Compared to invasive mole and choriocarcinoma group,the values of hydatidiform mole group of IFN-γ increased while IL-10 descended.There were significant difference between them(P<0.001).In hydatidiform mole patients:compared to the non-malignant groups,the values of Th1 cytokines(IFN-γ,IL-2) of malignant groups strongly decreased while the Th2 cytokines(IL-4,IL-10) strongly increased.All four cytokines had significant difference between two groups(P<0.001).With the increase of trophoblastic cell proliferation,all four cytokines changes were significantly statistical difference correlated with cell proliferation,except IL-4 in mild proliferation and middle proliferation was no difference(P>0.05).Conclusion:When Th1/Th2 cytokine shifts to Th2,The deterioration of hydatidiform mole is rising.