结直肠癌患者血清中免疫相关因子的表达水平及临床意义

郭小艳

doi:10.7619/jcmp.201917017

结直肠癌患者血清中免疫相关因子的表达水平及临床意义

郭小艳

Expression and significance of serum immune-related factors in patients with colorectal cancer

GUO Xiaoyan

摘要

摘要:
目的探讨外周血自然杀伤细胞(NK细胞)、CD3⁺、CD4⁺、CD8⁺、CD8⁺CD28^-及血清免疫相关因子肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-2、干扰素-γ(IFN-γ)、IL-22、IL-8在结直肠癌(CRC)患者中的表达水平及其临床意义。
方法选择80例结直肠癌(CRC)患者、54例慢性肠炎患者及36例健康志愿者分别作为肠癌组、良性组、健康组。测定各组受试者外周血NK细胞、CD3⁺、CD4⁺、CD8⁺、CD8⁺CD28^-含量及血清TNF-α、IL-2、IFN-γ、IL-22、IL-8水平。采用单因素ANOVA法分析3组受试者免疫相关指标, 同时选择非参数Kruskal Wallis秩和检验分析CRC患者免疫相关因子表达与病理分期间相关性。
结果 3组受试者外周血NK细胞、CD3⁺、CD4⁺、CD8⁺、CD8⁺CD28^-含量及血清TNF-α、IL-2、IFN-γ、IL-22、IL-8水平比较, 差异有统计学意义(P < 0.05); 与健康组相比，良性组和肠癌组患者外周血CD8⁺、CD8⁺CD28^-含量及血清TNF-α、IL-22、IL-8水平均显著上升, 而外周血NK细胞、CD3⁺、CD4⁺含量及血清IL-2、IFN-γ水平显著下降(P < 0.05); 与良性组相比, 肠癌组TNF-α、IL-22、IL-8水平及外周血CD8⁺、CD8⁺CD28^-含量显著上升, 血清IL-2、IFN-γ水平及外周血NK细胞、CD3⁺、CD4⁺含量显著下降(P < 0.05)。不同临床分期CRC患者血清TNF-α、IL-2、IFN-γ、IL-22、IL-8水平及外周血NK细胞、CD3⁺、CD4⁺、CD8⁺、CD8⁺CD28^-含量差异显著(P < 0.05), 从TNMⅠ期到TNM Ⅳ期, 患者血清TNF-α、IL-22、IL-8水平及外周血CD8⁺、CD8⁺CD28^-含量呈显著升高趋势, IL-2、IFN-γ水平及外周血NK细胞、CD3⁺、CD4⁺含量呈显著下降趋势。
结论免疫相关因子TNF-α、IL-2、IFN-γ、IL-22、IL-8及外周血免疫细胞在CRC发生发展过程中扮演重要角色, 可作为反映CRC进展及评估患者临床治疗效果的重要标志物。

Abstract:
Objective To explore the expression levels and significance of peripheral blood natural killer cells (NK), CD3⁺, CD4⁺, CD8⁺, CD8⁺CD28^- and the immune related factors such as tumor necrosis factor-α (TNF-α), interleukin (IL)-2, interferon-γ (IFN-γ), IL-22, IL-8 in patients with colorectal cancer (CRC).
Methods Totally 80 CRC patients, 54 patients with chronic enteritis and 36 healthy volunteers were selected as intestinal cancer group, benign group and healthy group. Serum levels of TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood NK, CD3^+, CD4⁺, CD8⁺, CD8⁺CD28^- were detected in all the groups. One-way ANOVA method was used to analyze the immune-related indexes. At the same time, the non-parametric Kruskal Wallis rank sum test was used to analyze the correlation between the expression of immune-related factors and pathological time in CRC patients.
Results There were significant differences in peripheral blood NK, CD3⁺, CD4⁺, CD8⁺, CD8⁺CD28^- levels and serum TNF-α, IL-2, IFN-γ, IL-22, IL-8 among the three groups (P < 0.05). Compared with the healthy group, the peripheral blood CD8⁺, CD8⁺CD28^- contents and serum TNF-α, IL-22, IL-8 levels significantly increased in the benign group and the intestinal cancer group, while the peripheral blood NK, CD3⁺, CD4⁺ and serum IL-2, IFN-γ levels significantly decreased (P < 0.05). Compared with benign group, the TNF-α, IL-22, IL-8 levels and peripheral blood CD8⁺, CD8⁺CD28ˉ contents increased significantly in the intestinal cancer group, while serum IL-2, IFN-γ levels and peripheral blood NK, CD3⁺, CD4⁺ levels significantly decreased (P < 0.05). There were significant differences in serum TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood NK, CD3⁺, CD4⁺, CD8⁺ and CD8⁺CD28^- levels in patients with different clinical stages of CRC (P < 0.05). From stage Ⅰ to Ⅳ of TNM, serum TNF-α, IL-22, IL-8 levels and peripheral blood CD8⁺, CD8⁺CD28^- levels significantly increased, while IL-2, IFN-γ levels and the contents of NK, CD3⁺ and CD4⁺ significantly reduced (P < 0.05).
Conclusion The immune-related factors such as TNF-α, IL-2, IFN-γ, IL-22, IL-8 and peripheral blood immune cells play important roles in the development of CRC, which can be used as important factors to reflect the progress of CRC and evaluate the clinical therapeutic effect of patients.

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