4-1BB/4-1BBL在胃癌组织及其外周血中的表达及临床意义

目的探讨胃癌局部免疫与全身免疫状态。方法应用流式细胞术,测定胃癌患者癌组织及外周血中T淋巴细胞亚群、NK细胞水平,同时测定癌组织、癌周正常胃黏膜、淋巴结及外周血单个核细胞中4-1BB、4-1BBL含量。结果胃癌患者外周血中CD3^＋、CD4^＋、CD4^＋/CD8^＋比值和NK细胞表达水平均显著高于胃癌组织（P〈0.05）,CD8^＋细胞计数反之（P〈0.05）。4-1BB表达量由低到高的顺序为外周血单个核细胞、正常胃黏膜、淋巴结、癌组织、癌组织中单个核细胞;其中癌组织明显高于正常黏膜（P〈0.05）,有统计学意义;外周血单个核细胞中4-1BB表达量明显低于其他组织,有统计学意义（P〈0.01）。癌组织中4-1BBL表达量低于正常黏膜,有统计学意义（P〈0.05）。癌组织中4-1BB表达量与CD4^＋/CD8^＋比值、NK细胞表达水平呈负相关关系,4-1BBL与CD4^＋/CD8^＋比值、NK细胞表达水平呈正相关关系,有统计学意义（P〈0.05）。结论胃癌组织内免疫力低下,处于免疫抑制状态,胃癌组织的低免疫状态与4-1BBL缺乏有关;4-1BB与胃癌患者局部和全身的免疫状态亦有密切关系。总之,胃癌组织中4-1BB/4-1BBL的表达失衡与胃癌的免疫逃逸、低免疫状态有关。

The Expressions and Clinical Signficance of 4-1BB and 4-1BBL in Gastric Cancer and Blood

Objective To study the local and total immune status in gastric cancer.Methods The protein expressions of 4-1BB,4-1BBL,and the amount of CD4^＋T,CD8^＋T,NK cells were detected by flow cytometry in the human tissues of gastric cancer,gastric mucosa,lymph cell,peripheral blood and lymph nodes.Results The amount of CD3^＋,CD4^＋,CD4^＋/CD8^＋ and NK cell in peripheral blood were higher than them in gastric cancer respectively and the amount of CD8＋ T cell were higher in gastric cancer than it in peripheral blood（P〈0.05）.The 4-1BB protein expressions were peripheral blood mononuclear cells,gastric mucosa,lymph nodes,gastric cancer,and mononuclear cells of cancer tissue in the sequence of from low to high.The expressions of 4-1BB protein in peripheral blood monocular cells were lower than those of other tissues（P〈0.05）;and the expression of 4-1BB protein in gastric cancer tissues was higher than gastric mucosa tissue（P〈0.05）.The expression of 4-1BBL protein in gastric cancer were lower than gastric mucosa（P〈0.05）.There was positive correlation between the expression of 4-1BB and the CD4^＋/CD8^＋、NK cells in gastric cancer tissue and there was positive correlation between the expression of 4-1BBL and the CD4^＋、CD8^＋、NK cells in gastric cancer tissue（P〈0.05）.Conclusion In gastric cancer tissue the immunity is low and inhibited which relates to the deficient in 4-1BBL.And the local and total immune status also relate to 4-1BB.The low immunity and immune escape are related to the disequilibrium expressions of 4-1BB/4-1BBL protein in the gastric cancer tissue.