胃癌患者化疗前后Th1/Th2细胞因子的检测及其临床意义

目的 研究胃癌患者化疗前后CD4+T淋巴细胞中Th1、Th2类细胞因子的表达水平和Th1/Th2值的变化及其临床意义.方法 60例胃癌患者接受FOLFOX4方案化疗,应用流式细胞仪对化疗前后患者外周血特异性细胞因子的表达变化进行分析.结果 化疗后,全组胃癌患者外周血CD4+T淋巴细胞分泌的γ干扰素(IFN-γ)的表达水平为11.4%±5.0%,较化疗前升高(P＜0.05);白介素10(IL-10)的表达水平为3.6%±1.2%,较化疗前降低(P＜0.05);Th1/Th2(IFN-γ/IL-4)的值为3.4±1.0,与化疗前比较,无明显变化(P＞0.05).15例化疗后疗效为部分缓解的患者,外周血CD4+T淋巴细胞分泌的IFN-γ和肿瘤坏死因子-α(TNF-α)的表达水平分别为14.8%±8.0%和5.9%±2.0%,均较化疗前升高(均P＜0.05);Th1/Th2(IFN-γ/IL-4)的值为4.0±1.5,明显高于化疗前水平(P＜0.01).结论 有效的化疗可减轻患者机体的肿瘤负荷,降低Th1类细胞因子向Th2类细胞因子漂移的程度;但胃癌化疗的有效率较低,因此对胃癌化疗者,改善机体免疫功能仍是很重要的治疗措施.

Pre-and post-chemotherapy expressions of Th1 and Th2 type cytokines and their clinical significance in gastric cancer patients

Objective To investigate the pre-and post-chemotherapy expression levels of Th1 and Th2 type cvtokines in peripheral blood CD4+ T lymphocytes,the changes of Th1/Th2 ratio and their clinical significanoe in patients with gastric cancer.Methods The Ievels of specific cytokines in 60 gastric cancer patients were detected by flow cytomctry before and after chemotherapy with FOLFOX4.Results The level of IFN-γ from peripheral blood CD4+T lymphocytes after chemotherapy in the whole group of gastric cancer patients was 11.4%±5.0%,significantly higher than that(9.5%±3.4%)before chemotherapy(P＜0.05).The level of IL-10 after chemotherapy was 3.6%±1.2%,significantly lower than that(4.2%±1.8%)before chemotherapy(P＜0.05).The ratio of Th1/Th2(IFN-γ/IL-4)after chemotherapy was 3.4±1.0 versus 3.4±1.6 before chemotherapy,without significant difierence(P＞0.05).Interestingly,the levels of IFN-γ and TNF-α of peripheral blood CD4+T lymphocytes in 15 gastric cancer patients who achieved partial response(PR)after chemotherapy were 14.8%±8.0%and 5.9%±2.0%,respectively,both were higher than that(6.9%±2.5%and 4.2%±1.3%)before chemotherapy(both P＜0.05).Furthermore,the ratio of Th1/Th2(IFN-γ/IL-4)after chemotherapy was 4.0±1.5,significantly higher than 2.5±1.2 before chemotherapy(P＜0.01).Conclusion Efiective chemotherapy may reduce the tumor burden and relieve the shift of Th1/Th2 ratio.Improvement in immune function may be a very important therapeutic measure due to poor response of chemotherapy in gastric cancer patients.