CD4+、CD8+和NK在结直肠癌中的表达及其与淋巴结微转移的关系

目的 检测不同Dukes分期结直肠癌患者淋巴结细胞角蛋白20(CK20)mRNA的表达及外周血CD4+、CD8+、CD4+/CD8+与NK细胞活性表达,探讨两者间关系.方法 采用常规苏木素.伊红(HE)染色病理切片检测21例结直肠癌患者281枚淋巴结转移癌灶及逆转录-聚合酶链反应(RT-PCR)方法检测患者淋巴结CK20 mRNA表达;采用流式细胞仪检测患者外周血CD4+、CD8+、CD4+/CD8+及NK细胞活性表达.结果 HE染色法检出有淋巴结转移者为16枚(6%,16/281),RT-PCR法检出有淋巴结转移者140枚(50%,140/281);按有淋巴结微转移重新Dukes分期后,手术前,A、B期患者血CD4+、CD4+/CD8+高于c期(P<0.05);A期患者血CD8+低于C期(P<0.05);B期患者血NK细胞活性高于C期(P<0.05).新Dukes分期与血CD4+呈负相关(r=-0.497,P<0.01);与CD4+/CD8+呈负相关(r=-0.714,P<0.01);与CD8+呈正相关(r=0.945,P<0.01).结论 RT-PCR方法对淋巴结微转移的检出率明显优于HE染色切片法,结直肠癌淋巴结微转移的发生与患者免疫功能明显低下密切相关.

Detection of CD4+ , CD8+ and NK in peripheral Mood of patients with colorectal cancer and its relationship with micrometastasis in regional lymph nodes

Objective To detect the positive rate of CK20 mRNA in regional lymph nodes and CD4+ ,CD8+ and NK cells in peripheral blood of colorectal cancer patients, and intestigate their relation-ship. Methods The positive rate of CD4+, CD8+ and NK cells in peripheral blood of 21 patients with colorectal cancer was detected by flow cytometry. The positive rate of CK20 mRNA in lymph nodes was tested by real time-polymerase chain reaction. The lymph node metastasis was examined pathologically. Re-suits For the opitive micrometastasis in regional lymph nodes patients,it was 16 nodes(6% ,16/281 ) by conventional pathological and 140 nodes (50%. 140/281 ) by real time-polymerase chain reaction, accord-ing to the opitive micrometastasis in regional lymph nodes restage the Dukes stage ,before the operation,the opitive rate of CD4+ , CD4+/CD8+ of patients in Dukes A and B were higher then Dukes C (P <0.05) ; and CD8+ in Dukes A patients were lower then Dukes C ( P < 0.05 ) ; and NK in Dukes B patients were higher then Dukes C ( P < 0. 05 ). The new Dukes stage was significantly correlated with CD4+ ( r = -0.497,P <0.01) ;CD4+/CD8+ (r = -0.714,P <0.01) ;CD8+ (r =0. 945,P <0.01 ). Conclusion For detecting the micrometastasis of lymph nodes, the method of realtime-pelymerase chain reaction were better than anventional pathological significantly, and the opitive micrometastasis in lymph nodes were cor-related significantly with the low immunity function of colorectal cancer patients.