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目的分析膀胱癌患者术前外周血中CD4~+CD25~+调节性T细胞(Treg)及CD8~+CD28~+细胞毒性T淋巴细胞(CTL)的表达水平。方法选取病理为低级别尿路上皮癌患者43例,高级别尿路上皮癌患者43例,以及未合并感染的肾囊肿患者20例为对照组。采用流式细胞技术检测外周血中CD4~+CD25~+Treg及CD8~+CD28~+CTL的表达水平,并探讨其表达与病理分级的关系。结果低级别和高级别尿路上皮癌患者外周血中CD4~+CD25~+Treg占CD4~+T细胞的比例分别为(6.58±2.93)%和(6.29±3.55)%,较对照组(4.55±2.83)%更高,差异具有统计学意义(P<0.05);低级别和高级别尿路上皮癌患者外周血中CD8~+CD28~+CTL占淋巴细胞比例分别为(6.57±3.30)%和(6.54±3.46)%,较对照组(8.81±3.78)%更低,差异具有统计学意义(P<0.05)。不同病理分级患者组间比较表明,低级别与高级别患者外周血中上述两种T细胞的比例差异无统计学意义(P>0.05)。结论膀胱尿路上皮癌患者外周血中CD4~+CD25~+Treg的表达增加,而主要的抗肿瘤效应细胞CD8~+CD28~+CTL表达降低,通过调节上述两类T细胞的表达水平,有望成为膀胱癌免疫治疗的新方向。
Objective To analyze the expression of CD4 ~ + CD25 ~ + regulatory T cells (Tregs) and CD8 ~ + CD28 ~ + cytotoxic T lymphocytes (CTLs) in peripheral blood of patients with bladder cancer before operation. Methods Forty-three patients with low grade urothelial carcinoma, 43 patients with high grade urothelial carcinoma, and 20 patients with uninfected renal cysts were selected as the control group. Flow cytometry was used to detect the expression of CD4 ~ + CD25 ~ + Treg and CD8 ~ + CD28 ~ + CTL in peripheral blood, and to explore its relationship with pathological grade. Results The proportion of CD4 ~ + CD25 ~ + Treg in CD4 ~ + T cells in peripheral blood of patients with low grade and high grade urothelial carcinoma were (6.58 ± 2.93)% and (6.29 ± 3.55)%, respectively, ± 2.83)%, the difference was statistically significant (P <0.05). The proportion of CD8 + CD28 + CTL in peripheral blood of patients with low-grade and high-grade urothelial carcinoma were (6.57 ± 3.30)% And (6.54 ± 3.46)%, respectively, which was lower than that of the control group (8.81 ± 3.78)%, the difference was statistically significant (P <0.05). The comparison of different pathological grading patients showed that there was no significant difference in the proportion of the above two kinds of T cells in peripheral blood of patients with low grade and high grade (P> 0.05). Conclusion The expression of CD4 ~ + CD25 ~ + Treg in the peripheral blood of patients with bladder urothelial carcinoma is increased, while the expression of CD8 ~ + CD28 ~ + CTL in the main anti-tumor effector cells is decreased. By regulating the expression of these two types of T cells, Become the new direction of bladder cancer immunotherapy.