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目的研究肺腺癌患者外周血中Th17细胞比例变化及其意义。方法收集28例肺腺癌患者与42例健康志愿者外周血标本。采用流式细胞术检测外周血Th17细胞比例,实时定量PCR技术检测外周血单个核细胞RORct、Foxp3mRNA表达水平,酶联免疫吸附法(ELISA)检测血清中IL-17A、TGF-β、IL-10的水平,所有标本同时进行肿瘤标志物系列检测。结果与健康对照组相比,肺腺癌患者外周血Th17细胞比例较健康对照组显著升高[1.19(0.89~1.88)%vs2.23(1.28~3.24)%,P=0.001],其特征性转录调控因子RORct及细胞因子IL-17A也明显升高(P<0.001,P=0.001)。外周血T调节细胞特征性转录调控因子Foxp3mRNA水平也显著升高(P=0.019),同时伴TGF-β及IL-10水平升高(P=0.014,P=0.003)。血清IL-17A与TGF-β之间呈显著正相关(P=0.006,r=0.497),外周血Th17细胞比例与CEA水平呈显著负相关(P=0.024,r=-0.502)。结论肺腺癌患者外周血Th17细胞比例及IL-17A水平显著高于健康对照组。Th17比例上调可能是肺腺癌患者免疫抑制的继发性改变。
Objective To study the changes of the proportion of Th17 cells in peripheral blood of patients with lung adenocarcinoma and its significance. Methods Peripheral blood samples from 28 patients with lung adenocarcinoma and 42 healthy volunteers were collected. The proportion of Th17 cells in peripheral blood was detected by flow cytometry. The expression of RORct and Foxp3 mRNA in peripheral blood mononuclear cells was detected by real-time quantitative PCR. The levels of IL-17A, TGF-β and IL-10 in serum were detected by enzyme-linked immunosorbent assay The level of all specimens at the same time a series of tumor markers testing. Results Compared with the healthy control group, the proportion of Th17 cells in peripheral blood of patients with lung adenocarcinoma was significantly higher than that of healthy controls [1.19 (0.89-1.88)% vs 2.23 (1.28-3.24)%, P = 0.001] The transcriptional regulators RORct and cytokine IL-17A also significantly increased (P <0.001, P = 0.001). The levels of Foxp3mRNA, a transcription factor that is characteristic of T regulatory cells in peripheral blood, were also significantly increased (P = 0.019), accompanied by increased levels of TGF-βand IL-10 (P = 0.014, P = 0.003). There was a significant positive correlation between serum IL-17A and TGF-β (P = 0.006, r = 0.497). The proportion of Th17 cells in peripheral blood was negatively correlated with CEA (P = 0.024, r = -0.502). Conclusion Th17 cells and IL-17A levels in peripheral blood of patients with lung adenocarcinoma were significantly higher than those in healthy controls. The up-regulation of Th17 may be a secondary change in immunosuppression in patients with lung adenocarcinoma.