胃癌患者血清细胞因子水平变化及与肿瘤分化程度的关系

目的探讨胃癌患者机体细胞免疫状态变化，为肿瘤免疫治疗提供依据。方法研究对象为山东大学附属省立医院2001年5月-2009年1月住院手术的胃癌患者78例（胃癌组）及同期健康体检者80例（对照组），两组均抽取空腹外周静脉血3ml（胃癌组术前），分离血清，-20℃冻存。采用ELISA法检测血清细胞因子IL-2、IFN-γ,IL4、IL-6、IL-10、IL-12水平。结果与对照组比较，胃癌组血清IL-2、IFN-γ及IL-12均显著降低，IL-4、IL-6和IL-10均显著升高（P〈0．05、0．001）；胃癌分化程度越低IL-2、IFN-γIL-γ2降低幅度及IL-4、IL-6、IL-10升高幅度越明显。结论胃癌患者处于Th2型细胞占优势的Th1／Th2细胞漂移状态，并与肿瘤分化程度相关；纠正Th1／Th2细胞漂移、诱导Th0细胞向Th1细胞增殖分化，有望促进机体免疫功能恢复、激活抗肿瘤免疫应答，进而提高肿瘤综合治疗效果。

Changes of cytokine level and its correlation with the tumor differentiation grade in patients with gastric cancer

Objective To investigate the changes of cellular immunity in patients with gastric cancer, so to provide basis for the immunotherapy of tumor. Methods The subjects were 78 patients with gastric cancer from Shandong provin- cial hospital （ gastric cancer group） and 80 healthy volunteers （ control group）, the peripheral vein blood （3 ml） was taken in the two groups, and then ELISA was used to measure the level of cytokines IL-2, IFN-γ, IL4, IL-6, IL-10, IL-12. Results Compared with the control group, the level of IL-2, IFN-γ and IL-12 increased significantly, the level of IL4, IL-6 and IL-10 decreased significantly（P 〈 0.05,0.01 ） ; decreasing or increasing percent of the level of IL-2, IFN-γ, IL- 12 and IL4, IL-6 enlarged, with the decreasing of tumor differentiation grade. Conclusions Th2 advantage can be seen in the Th1/Th2 shift of gastric cancer patients, and which is correlated with tumor differentiation grade ; to correct the Th1/ Th2 shift and induce Th0 cells proliferate to Th1 cells will improve the immune function, activate anti-tumor immune response, and to enhance the comprehensive effectiveness of tumor.