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目的:探讨大肠癌患者手术前后外周血淋巴细胞表型CD8、CD28变化及其临床意义。方法:应用CD8、CD28单克隆抗体,采用流式细胞术,对50例大肠癌组和30例对照组手术前及大肠癌组手术后PBL表型CD8、CD28进行测定。结果:肿瘤组淋巴细胞CD8的表达〔(32.24±8.38)%〕显著高于对照组〔(22.18±7.55)%〕,P<0.01;而CD28、CD8+/CD28+的表达则低于对照组〔(52.03±10.94)%vs(60.60±7.98)%,(12.18±4.28)%vs(16.38±4.94)%〕,P<0.01;根治切除肿瘤后,CD28、CD8+/CD28+的表达升高〔(54.95±8.63)%vs(52.35±7.56)%,(14.54±6.12)%vs(12.14±4.90)%〕,P<0.05;姑息切除肿瘤后,CD28、CD8+/CD28+的表达升高〔(55.18±3.12)%vs(51.85±6.18)%,(14.68±2.78)%vs(10.62±1.63)%〕,P<0.05;CD8的表达在行根治性肿瘤切除术后降低〔(29.66±8.58)%vs(32.04±10.01)%〕,P<0.05;而在姑息性切除肿瘤后则降低不明显〔(28.93±10.07)%vs(29.53±9.59)%〕,P>0.05;结论:大肠癌患者手术切除肿瘤后细胞毒T淋巴细胞CTL亚群免疫防御和免疫监视效应增强。观察淋巴细胞表型CD8、CD28变化,对大肠癌患者的免疫状态及预后监测具有一定的指导意义。
Objective: To investigate the changes of peripheral blood lymphocyte phenotypes CD8 and CD28 before and after surgery in patients with colorectal cancer and their clinical significance. Methods: Using CD8 and CD28 monoclonal antibodies and flow cytometry, the PBL phenotypes of CD8 and CD28 were measured in 50 patients with colorectal cancer and 30 patients in the control group before and after surgery. RESULTS: The expression of CD8 on the lymphocytes in the tumor group was significantly higher than that in the control group (22.18±7.55)%, P<0.01. The expression of CD28 and CD8+/CD28+ was lower in the tumor group than in the control group. 52.03±10.94)% vs (60.60±7.98)%, (12.18±4.28)% vs (16.38±4.94)%], P<0.01; After radical resection of tumors, the expression of CD28 and CD8+/CD28+ increased [(54.95± 8.63)%vs (52.35±7.56)%, (14.54±6.12)% vs (12.14±4.90)%], P<0.05; after palliative resection of tumors, the expression of CD28 and CD8+/CD28+ increased [(55.18±3.12) %vs (51.85±6.18)%, (14.68±2.78)% vs (10.62±1.63)%], P<0.05; CD8 expression was decreased after radical tumor resection [(29.66±8.58)% vs (32.04 ±10.01)%], P<0.05; but not significantly after palliative tumor resection ((28.93±10.07)% vs (29.53±9.59)%), P>0.05; Conclusion: Patients with colorectal cancer undergo surgical resection of the tumor The cytotoxic T lymphocyte CTL subsets have enhanced immune defense and immune surveillance. Observing the changes of CD8 and CD28 in lymphocyte phenotypes has certain guiding significance for the immune status and prognosis monitoring of colorectal cancer patients.