肺癌患者免疫功能变化测定及其临床意义

目的 探讨肺癌患者机体免疫功能变化及临床意义.方法 采用流式细胞术测定68例肺癌患者治疗前及20例健康志愿者外周静脉血中CD+3T、CD+4T、CD+8T、NK细胞以及Th1类细胞因子干扰素(INF)-γ、白细胞介素(IL)-2、肿瘤坏死因子(TNF)-α;Th2类细胞因子IL-4、IL-6、IL-10的水平.结果 肺癌患者外周血中CD+3T、CD+4T细胞、CD4/CD8值下降;CD+8T、NK细胞升高;TNF-α、IL-4、IL-6、IL-10水平均升高,Th1/Th2值降低,与对照组比较差异均有统计学意义,(P分别＜0.05～0.001).肺癌患者NK与CD3、CD4、CD8均呈负相关;CD4与Th2类细胞因子呈负相关.化疗前肺癌患者外周血淋巴细胞,Th1、Th2类细胞因子水平与病理类型、淋巴结转移、远处转移无关均(P＞0.05).结论 肺癌患者细胞免疫功能普遍低下,其中CD+4T细胞的数量和功能降低比较显著,其功能的降低可能与Th1/Th2因子失衡有关.

Detection and clinical significance of immune function in lung cancer patients

Objective To study the variety and significance of immune function in lung cancer patients.Methods 68 pretherapy lung cancer patients and 20 healthy volunteers with peripheral blood samples by flow cytometry.Results The proportion of CD+3T cells,CD+4T cells and the ratio of CD4/CD8 decreased in lung cancer patients,while the proportion of CD+8T cells and natural killer cells increased.Serum levels of TNF-α,IL-4,IL-6,IL-10 were significantly increased in patients compared with healthy controls,while the ratio of Th1/Th2 was decreased.(2)The natural killer cells level was negatively correlated with the CD3,CD4,CD8 levels respectively.The CD4 level was negatively correlated with the levels of IL-6,IL-10 respectively.(3)No statistically significant relationship was found between the peripheral blood lymphocyte,Th1-Th2 cytokines and pathological type,lymph node metastasis,distant metastasis.Conclusion Immune suppression was very common in lung cancer patients,particularly cell mediated immunity suppressed markedly.The proportion and function of CD+4T cells decreased significantly.which may resulted from the Th1,Th2 imbalance.Natural killer cells and CD+8T cells increased significantly,but could not prevent tumor development,which may resulted from these factors that suppress immune response in tumor microenvironment.