黄伟义, 刘汉锋①, 蔡正文①. 化疗对鼻型NK/T细胞淋巴瘤患者细胞免疫功能的影响[J]. 中国肿瘤临床, 2010, 37(14): 808-811. DOI: 10.3969/j.issn.1000-8179.2010.14.008
引用本文: 黄伟义, 刘汉锋①, 蔡正文①. 化疗对鼻型NK/T细胞淋巴瘤患者细胞免疫功能的影响[J]. 中国肿瘤临床, 2010, 37(14): 808-811. DOI: 10.3969/j.issn.1000-8179.2010.14.008
HUANG Weiyi1, LIU Hanfeng2, CAI Zhengwen2. Effect of Chemotherapy on Cellular Immunity of Patients with Nasal Natural Killer/TCell Lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(14): 808-811. DOI: 10.3969/j.issn.1000-8179.2010.14.008
Citation: HUANG Weiyi1, LIU Hanfeng2, CAI Zhengwen2. Effect of Chemotherapy on Cellular Immunity of Patients with Nasal Natural Killer/TCell Lymphoma[J]. CHINESE JOURNAL OF CLINICAL ONCOLOGY, 2010, 37(14): 808-811. DOI: 10.3969/j.issn.1000-8179.2010.14.008

化疗对鼻型NK/T细胞淋巴瘤患者细胞免疫功能的影响

Effect of Chemotherapy on Cellular Immunity of Patients with Nasal Natural Killer/TCell Lymphoma

  • 摘要: 目的:通过对鼻型NK/T细胞淋巴瘤患者化疗前、后外周血T 淋巴细胞各亚群及NK细胞检测来探讨化疗对其细胞免疫功能的影响。方法:分组对照研究,鼻型NK/T细胞淋巴瘤患者(实验组)41例,分别在化疗前及化疗2 个周期结束后10d 两次检测外周血T 淋巴细胞各亚群及NK细胞数目。正常健康组35例(对照组)。 对相关实验结果进行统计学分析。结果:鼻型NK/T细胞淋巴瘤患者化疗前与正常健康组相比,T 淋巴细胞亚群比例紊乱,CD3+、CD4+比例和CD4+/CD 8+比值及NK细胞明显下降,CD8+比例及CD4+CD25+调节性T 细胞(Tregulatory cells ,Treg )明显升高(P<0.05)。 经过2 个周期的化疗治疗,化疗有效组化疗后CD3+、CD4+比例、NK细胞比例、CD4+/CD 8+比化疗前明显升高(P<0.05),CD8+比例、CD4+CD25+Treg 明显下降(P<0.05)。 化疗有效组化疗后除CD4+、CD8+比例外,其他指标与正常健康组相比差别均无统计学意义(P>0.05);而无效组患者化疗后CD4+比例、CD8+比例、CD4+/CD 8+比值、NK细胞数目比化疗前则进一步下降(P<0.05)。 结论:鼻型NK/T细胞淋巴瘤患者细胞免疫功能低下,T 淋巴细胞亚群比例紊乱,NK细胞明显下降。有效化疗可通过杀伤、诱导肿瘤细胞凋亡,减轻肿瘤负荷,减少CD4+CD25+Treg ,排除某些免疫抑制因素;改善了患者的细胞免疫功能,化疗无效患者其细胞免疫功能则继续恶化。通过检测患者的T 淋巴细胞各亚群及NK细胞数变化可以反映患者的细胞免疫功能状态,对指导临床治疗、判断预后有重要的意义。

     

    Abstract: Objective:To elucidate the effect of chemotherapy on cellular immune function of patients with nasal Natu -ral Killer (NK)/T cell lymphoma through detection of the activity of T-lymphocyte subgroups and NK cells in peripheral blood of these patients before and after chemotherapy.Methods:A total of76cases in this controlled study were divided into 2 groups, i.e., the experimental group (EG) (41patients with nasal NK/T cell lymphoma) and the normal control group (CG) (35healthy participants without malignant tumors). Activity of the T-lymphocyte sub-groups and cell count of the NK cells in peripheral blood of the patients in the EG were each tested before chemotherapy and 10days after 2 cycles of chemical therapy. A statistical analysis of the related experimental results was conducted in the 2 groups. Results: In a comparison of the 2 groups, the proportion of the T-lymphocyte sub-groups was indiscriminate in the nasal NK/T cell lymphoma patients before chemotherapy, the proportion of T-lymphocyte subsets (CD 3 + , CD 4 + and the ratio of CD 4 +/CD8 + ) and values of Natural killer cells in patients with Nasal natural killer/T cell Lymphoma were significantly lower than that of the CG. The pro-portion of CD 3 + and CD4 +, and the specific values of CD4 +/CD8 +, as well as the proportion of NK cells greatly decreased, and the proportion of CD8 + and CD4 + CD25+ T-regulatory cells greatly increased compared with the control group (P < 0.05). After 2 cycles of chemotherapy, the values of CD 3 +, CD 4 +, Natural killer cells, and the ratio of CD 4 +/CD8 + were higher, while the values of CD 8 + and CD4 + CD25+ T-regulatory cells were lower compared to those in the group of pa-tients with improved condition (P<0.05). After the chemotherapy, apart from the proportion of CD4 + and CD8 +, there was no statistical significance in the differences between the other indicators in the group with improved patient condition and those in the control group ( P>0.05). However, in the patients with ineffective chemotherapy, the post-chemotherapeutic CD4 + and CD8 + proportions, CD4 +/CD8 + ratio and the number of NK cells further decreased compared to those before chemotherapy (P<0.05). Conclusion:Cellular immunity was suppressed and the ratio of T-lymphocyte subsets was vastly disordered in the patients with nasal NK/T cell Lymphoma. NK cells were remarkably decreased. By killing the tumor cells and inducing the apoptosis of tumor cells, effectual chemotherapy can lessen the tumor load, reduce the CD 4 + CD25+ T-reg cells, remove some immunosuppressive agents and improve cellular immunity, while the function of cellular immunity continues to worsen in the patients with failure of the chemotherapy. Detection of the T lymphocyte subsets and the change of NK cell counts may reflect the status of cellular immunity in patients, which is of great importance and significance in guiding clinical therapy and determining the prognosis.

     

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