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目的 了解在胃癌的发展过程中 ,肿瘤细胞与机体免疫系统间相互作用的特征。方法采用高敏感的放射性标记半定量RT PCR技术检测胃癌病人癌组织、非癌性粘膜组织及外周血各细胞亚群中细胞因子及T细胞受体亚家族mRNA的表达。结果 进展期胃癌外周血CD8+ T细胞中的增殖性T细胞克隆数低于早期胃癌 (P =0 .0 5 )。有淋巴结转移病例外周血CD8+ T细胞和CD4 + T细胞中的增殖性T细胞克隆数较无转移组明显减少 (P =0 .0 0 0 17、P =0 .0 16 )。有淋巴结转移病例的癌组织 ,其CD8+ T细胞中IL 6、IL 8、TNF α和CD4 + T细胞中IL 4mRNA的水平 (0 .4 3± 0 .17、0 .4 2± 0 .11、0 .18± 0 .0 5、0 .0 8± 0 .0 3)均较非癌性粘膜组织中的 (0 .0 8± 0 .0 2、0 .17± 0 .0 5、0 .0 8± 0 .0 3、0 .0 1± 0 .0 0 )增高 (P =0 .0 4 0、P =0 .0 2 0、P =0 .0 17、P =0 .0 34) ;而无淋巴结转移病例的癌组织与非癌性粘膜组织中各细胞因子的表达均未发现统计学差异。结论 胃癌病人T细胞受体库及细胞因子表达与胃癌进展及转移相关 ,进展期胃癌及发生转移的病例免疫系统受到抑制。
Objective To understand the characteristics of the interaction between tumor cells and the immune system during the development of gastric cancer. Methods Semi-quantitative RT-PCR was used to detect the expression of cytokines and T cell receptor subfamilies in gastric cancer, non-cancerous mucosa and peripheral blood. Results The number of proliferating T cells in CD8 + T cells in advanced gastric cancer was lower than that in early stage gastric cancer (P = 0.05). The number of proliferating T cells in peripheral blood CD8 + T cells and CD4 + T cells with lymph node metastasis was significantly lower than that without metastasis (P = 0.0107, P = 0.016). The levels of IL-4 mRNA in IL-6, IL-8, TNF-alpha and CD4 + T cells in CD8 + T cells in cancer tissues with lymph node metastases (0.334 ± 0.17,0.42 ± 0.11, 0 .18 ± 0 .0 5,0. 0 8 ± 0 .0 3) were significantly higher than those in non-cancerous mucosa (0 .8 ± 0. 0 2 .017 ± 0 .0 5,0. 0 8 ± 0 .0 3,0 .0 1 ± 0 .0 0) increased (P = 0. 0 4 0, P = 0. 0 2 0, P = 0. 0 17, P = 0. 0 34) There was no significant difference in the expression of various cytokines in cancerous and non-cancerous mucosa without lymph node metastasis. Conclusion The expression of T cell receptor and cytokines in gastric cancer patients is related to the progression and metastasis of gastric cancer, and the immune system of patients with advanced gastric cancer and metastasis is inhibited.