肺癌患者外周血中髓源性抑制细胞的比例及其意义

目的: 研究肺癌患者外周血中髓源性抑制细胞(myeloid derived suppressor cells，MDSCs)比例的变化，分析其与T淋巴细胞亚群的关系及临床意义。方法: 选取20名健康体检者和30例肺癌患者，收集其外周血；此外，选择其中15例术后30 d的肺癌患者，收集其外周血。用流式细胞术检测外周血中HLA DRˉCD33+CD11+MDSCs比例和T淋巴细胞亚群的比例,并分析两者的相关性。结果： 与健康对照相比，肺癌患者外周血中HLA DR-CD33+CD11+ MDSCs比例明显增高(P<0.05)。肺癌患者CD3+T细胞、CD4+T细胞、CD4+/CD8+T细胞比值均明显低于健康对照(P<0.05)，但CD8+T细胞比例明显高于健康对照(P<0.05)。肺癌患者术后外周血中MDSCs比例明显低于术前(P<0.05)。淋巴结转移患者外周血中MDSCs比例明显高于无淋巴结转移患者(P<0.05)，Ⅲ～Ⅳ期肺癌患者明显高于Ⅰ～Ⅱ期患者(P<0.05)。肺癌患者外周血中MDSCs比例与CD4+T细胞比例呈负相关(r=-0.524 4,P<0.01)，与CD8+T细胞比例呈正相关(r=0.444 9,P<0.05)。 结论： 肺癌患者外周血中MDSCs比例增高，与T淋巴细胞亚群数量相关，可能对机体免疫具有抑制作用。

Proportion of myeloid derived suppressor cells in peripheral blood of patients with lung cancer and its significance

Objective: To study the changes of the proportion of myeloid derived suppressor cells(MDSCs) in the peripheral blood of patients with lung cancer, and to analyze its relationship with T lymphocyte subsets, and its clinical significance. Methods: A total of 20 healthy people and 30 lung cancer patients were selected and their peripheral blood samples were also collected. In addition, 15 lung cancer patients who were 30 days after operation were selected and their peripheral blood samples were also collected. The proportion of HLA DR-CD33+ CD11+MDSCs and the proportion of T lymphocyte subsets in peripheral blood were detected by flow cytometry. The proportion of MDSCs and their correlation with T lymphocyte subsets were analyzed. Results: Compared with healthy controls, the proportion of HLA DRˉCD33+CD11+ MDSCs in peripheral blood of patients with lung cancer was significantly increased (P<0.05). The proportion of CD3+T cells, CD4+T cells and CD4+/CD8+ in lung cancer patients were significantly lower than those in healthy controls (P<0.05), while the proportion of CD8+T cells was higher than healthy controls(P<0.05). The level of MDSCs in peripheral blood of patients with lung cancer after operation was lower than that before operation (P<0.05). The proportion of MDSCs in peripheral blood of patients with lymph node metastasis was significantly higher than that without lymph node metastasis (P<0.05). The peripheral blood of patients with lung cancer at stage Ⅲ-Ⅳ was higher than that at stage Ⅰ-Ⅱ(P<0.05). The proportion of MDSCs in peripheral blood of patients with lung cancer was negatively correlated with the proportion of CD4+ T cells(r=-0.524 4,P<0.01), and positively correlated with the proportion of CD8+ T cells(r=0.444 9,P<0.05). Conclusion: The proportion of MDSCs in peripheral blood of patients with lung cancer was increased and correlated with the number of T lymphocyte subsets, which might exert immunosuppressive effect on the organisms.