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热化疗对晚期恶性肿瘤患者外周血CD8+CD28+ T细胞表达的影响及临床意义

Influence and Clinical Significance of Thermochemotherapy on Expression of CD8+CD28+ T Subtype Cells in Peripheral Blood of Patients with Advanced Malignant Tumors

  • 摘要: 目的探讨热化疗对晚期肺癌、大肠癌、乳腺癌患者外周血CD8+CD28+T细胞亚群(CTL)表达的影响及临床意义。方法晚期肺癌、乳腺癌、大肠癌患者各20例,随机分为热化疗与化疗两组,每组肺癌、乳腺癌、大肠癌患者各10例,热化疗组每周期化疗予以同步全身热疗,至少完成两个周期治疗,正常健康志愿者20例作为健康对照,用流式细胞仪检测外周血CD4+、CD8+、CD8+CD28+T细胞亚群。结果与健康对照组相比,肿瘤患者外周血T细胞CD4+ 、CD8+及CD4+/CD8+的表达差异无统计学意义(P>0.05),CD8+CD28+的表达显著降低(P<0.05),热化疗组患者治疗后T细胞CD8+CD28+表达上调,与治疗前比较差异有统计学意义(P<0.05),化疗组患者治疗前后T细胞CD8+CD28 +的表达差异无统计学意义(P>0.05),热化疗组患者的有效率、生存质量优于化疗组患者(P<0.05), 两组治疗的Ⅲ~Ⅳ度骨髓抑制及消化道反应比较差异无统计学意义(P>0.05),T细胞CD8+CD28+的表达与肿瘤病理类型无关。结论晚期肿瘤患者T细胞存在共刺激分子CD28表达的低下及肿瘤细胞的免疫逃逸,热化疗能上调T细胞CD8+CD28+的表达,增强肿瘤患者的免疫监视功能,在疗效与预后上较化疗有优势。

     

    Abstract: ObjectiveTo explore the influence and clinical significance of thermochemotherapy on the expression of CD8+CD28+T (CTL),subtype cells in peripheral blood of patients with advanced lung cancer,colorectal cancer or breast cancer. MethodsAdvanced patients with lung cancer,colorectal cancer or breast cancer (20 cases, respectively) were divided into two groups with thermochemotherapy and chemotherapy randomly.There were 10 coses of lung cancer,colorectal cancer or breast cancer patients were in each group.Thermochemotherapy group was given whole body thermotherapy concurrently with each cycle chemotherapy.Two cycles treatment were given to them.20 healthy volunteers were used as control.The T subtype cells of CD4+,CD8+ and CD8+CD28+ in peripheral blood were analyzed by flow cytometry. ResultsT subtype cells of CD4+,CD8+ and CD4+/CD8+ of the malignant group showed no significance compared with the normal group(P>0.05), CD8+CD28+ expressed lower and could be upregulated significantly after thermochemotherapy(P<0.05).There were no significance prior and after chemotherapy(P>0.05).The response rate and quality of life of thermochemotherapy group were better than those of chemotherapy group(P<0.05),3 to 4 grade bone marrow suppression and response of digestive tract showed no significance after treatment in the two groups(P>0.05).T subtype cells of CD8+CD28+ showed no correlation with tumor pathological type. ConclusionThe costimulatory molecule of CD28 of T cells expressed lower and existing tumor cells immune escape in advanced malignant patients,thermochemotherapy can upregulate expression of CD8+CD28+ on peripheral T cells,enhance immune surveillance function,showing advantage on curative effect and prognostic compare with chemotherapy.

     

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