不同分期肺腺癌患者外周血淋巴细胞亚群和细胞因子的变化

目的]探讨不同分期肺腺癌患者外周血淋巴细胞亚群含量、γ干扰素（IFN-γ）和白细胞介素-4（IL-4）水平的变化。方法]用直接免疫荧光—流式细胞技术检测37例（Ⅰ期5例、Ⅱ期7例、Ⅲ期11例、Ⅳ期14例）肺腺癌患者外周血淋巴细胞亚群含量,ELISA法检测外周血清细胞因子IL-4、INF-γ水平。10例正常人作为对照。结果]①与正常对照组相比,肺腺癌患者CD3＋CD4＋T细胞亚群比例显著性降低（P=0.000）,且Ⅰ～Ⅱ期明显高于Ⅲ～Ⅳ期（P=0.000）;②CD4＋/CD8＋比值与CD16＋CD56＋比例在肺腺癌Ⅲ、Ⅳ期组明显低于Ⅰ、Ⅱ期和正常对照组（P=0.000）;③与肺癌Ⅰ、Ⅱ期及对照组相比,Ⅲ、Ⅳ期患者血清IL-4水平明显升高,INF-γ水平明显降低（P=0.000）;Ⅳ期IL-4水平高于Ⅲ期（P=0.003）,INF-γ水平低于Ⅲ期（P=0.03）。结论]不同临床分期肺腺癌患者细胞免疫功能有差异,检测外周血淋巴细胞亚群及细胞因子可反映患者的免疫状况。

The Changes of Peripheral Blood Lymphocyte Subsets and Cytokine in Patients with Lung Adenocarcinoma at Different Stages

Purpose] To investigate the changes of peripheral blood lymphocyte subsets INF-γ and IL-4 level of lung adenocarcinoma at different stages. Methods] Values of peripheral blood lymphocyte subsets in 37 cases with lung adenocarcinoma（5 cases with stageⅠ; 7 cases, stageⅡ, 11 cases, stage Ⅲ; and 14 cases, stage Ⅳ） were examined by flow cytometry. The levels of INF-γ and IL-4 were detected by ELISA method. Ten healthy persons as control group. Results] ①The values of peripheral blood CD3＋ CD4＋ in lung adenocarcinoma group were lower than that in control group （P=0.000）, and those with stageⅠ, Ⅱ were higher than those with stage Ⅲ, Ⅳ （P=0.000）. ②The values of peripheral blood CD4＋/ CD8＋ and CD16＋CD56＋ in stage Ⅲ, Ⅳ group were lower than those in stageⅠ, Ⅱand control group （P= 0.000）. ③Compared with stageⅠ, Ⅱand control group, the level of IL-4 was significantly increased and INF-γ was significantly reduced in stage Ⅲ, Ⅳ group （all P=0.000）. The level of IL-4 in stage Ⅳ was higher than that in stage Ⅲ（P=0.003）, and INF-γ was lower than that in stage Ⅲ（P=0.03）. Conclusion] Different cellular immunity was found in patients with lung adenocarcinoma at different stages. Detection of peripheral blood lymphocyte subsets and cytokines may reflect the immune status.