结直肠癌患者与健康受试者外周血CD45RA+/CD45RO+淋巴细胞表型分析

目的 分析结直肠癌患者与健康受试者外周血CD45RA+/CD45RO+系列T淋巴细胞表达的差异.方法 运用流式细胞术(FCM)检测2010年1月至2013年12月解放军总医院收治的109例结直肠癌患者(试验组)与64例健康受试者(对照组)外周血CD45RA+、CD45RO+、CD4+ CD45RA+、CD4+ CD45RO+T淋巴细胞亚群表达情况,统计分析试验组和对照组性别和年龄的分布是否存在差异,然后进一步分析CD45 RA等T淋巴细胞亚群与结直肠癌临床分期的关系.结果Ⅰ+Ⅱ期、Ⅲ期和Ⅳ期结直肠癌患者外周血CD45 RA+细胞百分率三者分别为(56.23±7.75)％、(58.86±7.66)％和(59.02±9.71)％]明显高于对照组(48.94±12.66)％],差异具有统计学意义(F=11.128,P＜0.001);Ⅲ期和Ⅳ期患者的CD45RO+细胞百分率分别为(47.19±8.30)％和(45.41±10.45)％]则明显低于对照组(53.43±11.75)％],差异具有统计学意义(F=5.817,P=0.00083);Ⅲ期和Ⅳ期患者CD45RA+/CD45RO+的比值(分别为1.32 ±0.46和1.43±0.63)明显高于对照组(1.00±0.47),差异具有统计学意义(F=6.986,P=0.000185);Ⅰ+Ⅱ期患者CD4+ CD45 RO+细胞百分率(31.37±6.39)％]明显高于对照组(27.49±7.19)％],差异具有统计学意义(F=2.368,P=0.009);Ⅳ期患者CD4+ CD45RA+/CD4+ CD45RO+的比值(0.66±0.39)明显高于Ⅰ+Ⅱ期的患者(0.49±0.23),差异具有统计学意义(F=1.812,P=0.029);各组之间CD4+ CD45RA+细胞百分率无明显统计学差异(F=0.637,P=0.592).结论 随着临床分期的增加,结直肠癌患者外周血CD45RA+细胞逐渐增加而CD45RO+细胞逐渐减少,反映出结直肠癌患者随着肿瘤的进展其免疫功能逐渐抑制、逐渐降低的动态过程;CD4+ CD45RA+细胞和CD4+ CD45RO+细胞在反映结直肠癌患者机体免疫功能方面不如CD45RA+细胞和CD45RO+细胞敏感.

An Analysis of CD45RA +/ CD45RO + Lymphocytes Phenotype Between Colorectal Carcinoma Patients and Healthy Individuals

Objective To analyze the difference in CD45RA+/ CD45RO+ expression in T lymphocytes in peripheral blood of colorectal cancer (CRC) patients and healthy subjects.Methods A total of 109 CRC patients(case group) and 64 healthy subjects (control group) were recruited in the General Hospital of People's Liberation Army from January 2010 to December 2013.The expressions of CD45RA+,CD45RO +,CD4+ CD45RA+ and CD4+ CD45RO+ in T lymphocyte subsets in peripheral blood were detected.The difference in sex and age distribution was statistically analyzed between the case group and the control group.The association between T lymphocyte subsets(such as CD45RA) and the clinical stages of CRC patients were further analyzed.Results The percentages of CD45RA+ in peripheral blood in the case group were significantly higher at stages of Ⅰ + Ⅱ,Ⅲ and Ⅳ (56.23％ ± 7.75)％,(58.86％ ± 7.66)％ and (59.02 ± 9.71)％,respectively,F=11.128,P ＜0.001 =than that in the control group (48.94 ± 12.66)％];The percentages of CD45RO+ in the case group were significantly lower at stage Ⅲ and Ⅳ (47.19 ± 8.30)％ and(45.41 ± 10.45) ％,respectively,F =5.817,P =0.00083] than that in the control group (53.43％ ± 11.75)％;The ratios of CD45RA +/CD45RO+ in the case group were significantly higher at stage Ⅲ and Ⅳ (1.32 ± 0.46 and 1.43 ± 0.63,respectively,F =6.986,P =0.000185) than that in the control group (1.00 ± 0.47);The percentage of CD4 + CD45RO + in the case group was significantly higher at stage Ⅰ + Ⅱ (31.37 ± 6.39) ％,F =2.368,P =0.009] than that in the control group (27.49 ± 7.19) ％.In the CRC patients,the ratio of CD4 + CD45RA+/CD4 + CD45RO+ at stage Ⅳ was significantly higher(0.66 ± 0.39,F =1.812,P =0.029) than that at stage Ⅰ + Ⅱ (0.49 ± 0.23).There was no significant difference in the percentage of CD4 + CD45RA + between the two groups(F =0.637,P =0.592).Conclusion The CD45RA + expression increased while CD45RO + expression decreased in peripheral blood along with clinical stage,suggesting that immunosuppression existed in CRC patients coupled with reduced resistance against tumor progression.CD4+CD45RA+ cells and CD4+ CD45RO+ cells were less sensitive in indicating the immunity status in CRC patients,than CD45RA + cells and CD45RO + cells.