老年肺癌患者血清T淋巴细胞亚群CD28的检测及临床意义

目的：探讨老年肺癌患者淋巴细胞免疫功能状态、临床意义及与肺癌病理类型、临床分期的关系。方法：采用三色免疫荧光标记流式细胞术检测35名正常老年人及32例老年肺癌患者外周血的总T淋巴细胞（CD3^＋）、辅助／诱导T淋巴细胞（CD4^＋）、抑制／细胞毒T淋巴细胞（CD8^＋）、细胞毒T细胞（CD8^＋CD28^＋）和抑制T细胞（CD8^＋CD28）。结果：老年肺癌组CD4^＋Tz细胞（t=2．01，P〈0．05）和CD3^＋、CD8^＋T细胞及CD8^＋CD28^＋T细胞亚群明显低于老年正常对照组，t=2．01，P〈0．01；CD8^＋CD28T细胞亚群明显高于老年正常对照组，t=2．01，P〈0．01；老年肺癌患者中，T淋巴细胞及亚群CD28的表达在TNM临床分期及病理类型间差异均无统计学意义，t=2．11，P值均〉0．05。结论：老年肺癌患者存在明显的T淋巴细胞亚群免疫功能紊乱，抗肿瘤能力明显下降，并导致病情恶化更严重，且与病理类型及临床分期无关。

Change of expression of CD28 on T-lymphocyts in peripheral blood in elderly patients with lung cancer

OBJECTIVE:To investigate the change of the expression of CD28 on T-lymphocyts in peripheral blood in elderly patients with lung cancer and to study clinical significance and immunity function and the relations of these changes with clinical stages and pathological types.METHODS:Three-color fluorescent flow cytometry was used to analyze the percentage of peripheral blood CD3+,CD4+,CD8+ T-lymphocyts and CD8+ CD28+,CD8+ CD28-T cell subsets in both of 35 normal elderly persons and 32 elderly patients with lung cancer.RESULTS:CD4+T cells(t=2.01,P<0.05) and CD3+,CD8+,CD8+CD28+T cells(t=2.01,P<0.01) in the peripheral blood of the elderly patients with lung cancer were significantly lower than those in the normal elderly person;CD8+CD28-(t=2.01,P<0.01) T cells in the peripheral blood of the elderly patients with lung cancer were significantly higher than those in the normal elderly persons.However there was no significant difference between different clinical stages and pathological types,t=2.11,P>0.05.CONCLUSION:Elderly group patients with lung cancer have a significantly lower cellular immunity dysfunction and anticancer ability than those in normal elderly persons,which leads to their illness worsening,but has no obvious relations with the clinical stages and pathological types.