Th1、Th2、Th17型细胞因子在肺癌中的表达及其临床意义

发布时间：2018-04-03 22:40

  本文选题：肺癌　切入点：外周血　出处：《河北医科大学》2017年硕士论文

【摘要】：目前,肺癌已成为全球常见恶性肿瘤之一且生存率低,虽采用手术、化疗、放疗等方式进行治疗,依然无法显著降低肺癌死亡率。随着分子生物学和免疫技术的飞速发展,为肺癌的免疫治疗提供了更充足的理论基础和实践经验。免疫治疗在肺癌的综合治疗中发挥着越来越显著的作用,有望成为治愈肺癌的方法之一。免疫应答是一个系统、连续而复杂的过程,随着人们对免疫调节机制的深入研究,细胞因子在抗肿瘤免疫反应中的重要作用逐渐被重视,细胞因子及分泌细胞因子的淋巴细胞的研究将成为肿瘤生物治疗领域的研究热点,应用前景良好。肿瘤细胞打破局部及外周血中免疫细胞、细胞因子之间的平衡。近来新型辅助性T细胞-Th17被识别,以分泌IL-17为特点,介导炎症反应和自身免疫性疾病等的发展。目的:应用流式细胞微球阵列术(CBA)检测肺癌患者外周血中Th1、Th2、Th17多个细胞因子的表达水平,探讨细胞因子的改变在肺癌外周血免疫微环境中的表达及其临床意义。方法:1研究对象筛选在河北大学附属医院住院治疗病人中选取确诊的肺癌患者50例作为实验组,健康体检者为对照组。对照组患者无合并其他疾病。2血清样本收集实验组患者分别于化疗前和2周期化疗后采血,清晨分别抽取两组患者空腹外周血5 ml,对照组于清晨空腹采取外周血5ml,分别离心取上清,作好标记。3效应因子检测应用流式细胞微球阵列术试剂盒分别检测外周血中Th1(TNF-α、IFN-γ、IL-2)、Th2(IL-4、IL-6、IL-10)、Th17(IL-17)细胞因子浓度。结果:1化疗前实验组和对照组细胞因子变化和对照组相比,化疗前实验组细胞因子Th2(IL-4、IL-6、IL-10)、Th17(IL-17)等的水平显著升高(P0.05),而Th1(TNF-α、IFN-γ、IL-2)水平显著降低(P0.05)。2化疗前和化疗后细胞因子变化和化疗前相比,化疗后实验组细胞因子Th2(IL-4)、Th17(IL-17)等的水平显著降低(P0.05),Th2(IL-6、IL-10)有下降趋势,但无统计学差异(P0.05);Th1(TNF-α、IFN-γ、IL-2)水平显著升高(P0.05)。3化疗后实验组和对照组和对照组相比,化疗后实验组细胞因子Th2(IL-4、IL-6、IL-10)、Th17(IL-17)等的水平显著升高(P0.05),Th1(TNF-α、IFN-γ、IL-2)水平显著降低(P0.05)。但是化疗前细胞因子变化幅度水平减小。4在健康人群中,IL-17与Th1和Th2型细胞因子之间无明显相关性(P0.05);在肺癌患者中IL-17与Th1型细胞因子IFN-γ、IL-2和Th2型细胞因子IL-6、IL-10显著相关(P0.05);结论:1肺癌患者外周血中Th1型细胞因子下降、Th2、Th17型细胞因子上调,提示这可能是肺癌免疫功能下降的原因,与肺癌发生、发展有关。2化疗有效后有可能改善肺癌患者免疫功能。
[Abstract]:At present, lung cancer has become one of the most common malignant tumors in the world and the survival rate is low. Although surgery, chemotherapy, radiotherapy and other methods are used to treat lung cancer, the mortality rate of lung cancer can not be significantly reduced.With the rapid development of molecular biology and immune technology, it provides more theoretical basis and practical experience for immunotherapy of lung cancer.Immunotherapy plays a more and more important role in the comprehensive treatment of lung cancer and is expected to be one of the methods to cure lung cancer.Immune response is a systematic, continuous and complex process. With the in-depth study of immunomodulatory mechanism, the important role of cytokines in anti-tumor immune response has been paid more and more attention.The study of cytokines and cytokine secreting lymphocytes will become a hot topic in the field of tumor biotherapy.Tumor cells break the balance between immune cells and cytokines in local and peripheral blood.Recently, novel helper T cells-Th17 have been recognized, characterized by the secretion of IL-17, mediating inflammatory response and autoimmune diseases.Objective: to detect the expression of more than Th1 Th2Th17 cytokines in peripheral blood of lung cancer patients by flow cytometry microsphere array (CBA), and to investigate the expression of cytokines in peripheral blood immune microenvironment of lung cancer and its clinical significance.Methods Twenty one subjects were selected from the hospitalized patients in affiliated Hospital of Hebei University. 50 patients with lung cancer were selected as the experimental group and the healthy persons as the control group.The control group had no other diseases. 2 serum samples were collected from the patients in the experimental group before and after 2 cycles of chemotherapy.In the morning, the fasting peripheral blood of the two groups were drawn from 5 ml, while the control group took 5 ml of peripheral blood on an empty stomach in the morning, and centrifuged the supernatant respectively.缁撴灉:1鍖栫枟鍓嶅疄楠岀粍鍜屽�圭収缁勭粏鑳炲洜瀛愬彉鍖栧拰瀵圭収缁勭浉姣�,鍖栫枟鍓嶅疄楠岀粍缁嗚優鍥犲瓙Th2(IL-4,IL-6,IL-10),Th17(IL-17)绛夌殑姘村钩鏄捐憲鍗囬珮(P0.05),鑰孴h1(TNF-伪,IFN-纬,IL-2)姘村钩鏄捐憲闄嶄綆(P0.05).2鍖栫枟鍓嶅拰鍖栫枟鍚庣粏鑳炲洜瀛愬彉鍖栧拰鍖栫枟鍓嶇浉姣，

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