髓源性抑制细胞和调节性T细胞在膀胱尿路上皮癌患者外周血及癌组织中的表达及意义

发布时间：2018-03-29 00:30

本文选题：膀胱尿路上皮癌　切入点：髓源性抑制细胞　出处：《昆明医科大学》2014年硕士论文

【摘要】：目的：通过检测膀胱尿路上皮癌患者外周血、癌组织及癌旁组织中髓源性抑制细胞(myeloid derived suppressor cells, MDSC)与调节性T细胞(regulatory T cells, Treg)的表达水平,探讨其与膀胱尿路上皮癌临床病理特征之间的关系及它们之间的相关性,为膀胱尿路上皮癌的早期诊断、治疗和判断预后提供依据。方法：选取昆明医科大学第二附属医院泌尿外科2012年12月至2013年11月收治的膀胱尿路上皮癌患者39例和体检中心20例健康体检者,采集其外周血；39例膀胱尿路上皮癌患者手术后收集切除的癌组织以及距肿瘤2cm以外正常膀胱组织。用流式细胞术分别检钡CD14-CD11b+CD33+MDSC与CD4+CD25+Foxp3+Treg的表达。结果： 1.膀胱尿路上皮癌患者外周血中MDSC、Treg的表达显著高于健康者,差异有统计学意义(p0.05)； 2.膀胱尿路上皮癌癌组织中MDSC、Treg的表达显著高于癌旁组织,差异有统计学意义(p0.05)； 3.膀胱尿路上皮癌患者外周血、癌组织、癌旁组织中MDSC、Treg的表达水平与临床分期、组织学分级、淋巴结有无转移相关(p0.05),未观察到MDSC、 Treg表达水平与患者性别、年龄、肿瘤直径、肿瘤数量、肿瘤复发有关(P0.05)；临床分期与组织学分级、淋巴结有无转移相比,临床分期与MDSC、Treg的表达水平相关性更大(P0.05)。 4膀胱尿路上皮癌患者外周血、癌组织、癌癌旁组织中的MDSC与Treg表达水平均呈正相关关系,每对数据间均有统计学意义(P0.05)。 5膀胱尿路上皮癌患者的外周血及癌组织中的MDSC水平高于癌旁组织中的MDSC(P0.05);膀胱尿路上皮癌患者的外周血及癌旁组织中的Treg水平低于癌组织中的Treg (P0.05)。结论：膀胱尿路上皮癌患者外周血及癌组织中MDCS、Treg细胞的比例明显增加且与临床分期、病理分级、淋巴结有无转移相关,其可能与膀胱尿路上皮癌细胞的免疫逃逸相关,并可能在膀胱尿路上皮癌的发生发展中起重要作用,其具有成为膀胱尿路上皮癌免疫治疗靶点的潜在价值。
[Abstract]:Objective:. The expression of myeloid derived suppressor cells (MDSCs) and regulatory T cells (Tregs) in peripheral blood, cancer tissues and adjacent tissues of bladder urothelial carcinoma patients were detected. To explore the relationship between bladder urothelial carcinoma and clinicopathological features and their correlation, to provide evidence for early diagnosis, treatment and prognosis of bladder urothelial carcinoma. Methods:. From December 2012 to November 2013, 39 patients with bladder urothelial carcinoma and 20 healthy persons in the center of physical examination were selected from Urology Department, second affiliated Hospital of Kunming Medical University, from December 2012 to November 2013. CD14-CD11b CD33 MDSC and CD4 CD25 Foxp3 Treg were detected by flow cytometry in 39 patients with bladder urothelial carcinoma and normal bladder tissues other than 2cm. Results:. 1. The expression of MDSC-Treg in peripheral blood of patients with bladder urothelial carcinoma was significantly higher than that of healthy controls (P 0.05). 2.The expression of MDSC-Treg in bladder urothelial carcinoma was significantly higher than that in paracancerous tissues (P 0.05). 3.The expression of MDSC-Treg in peripheral blood, cancer tissue and adjacent tissues of bladder urothelial carcinoma was correlated with clinical stage, histological grade and lymph node metastasis (P 0.05). There was no correlation between MDSCand Treg expression and sex, age, tumor diameter. The correlation between clinical stage and histological grade, lymph node metastasis, clinical stage and MDSC-Treg expression level was greater than that between clinical stage and MDSC-Treg expression level. (4) there was a positive correlation between the expression of MDSC and Treg in peripheral blood, cancer tissues and paracancerous tissues of patients with bladder urothelial carcinoma, and there was significant difference between each pair of data (P 0.05). (5) the level of MDSC in peripheral blood and cancer tissue of bladder urothelial carcinoma was higher than that in paracancerous tissue (P 0.05), and the level of Treg in peripheral blood and adjacent tissue of bladder urothelial carcinoma was lower than that in cancer tissue (P 0.05). Conclusion:. The percentage of MDCS- Treg cells in peripheral blood and cancer tissues of patients with bladder urothelial carcinoma was significantly increased and correlated with clinical stage, pathological grade and lymph node metastasis, which may be related to immune escape of bladder urothelial carcinoma cells. It may play an important role in the occurrence and development of bladder urothelial carcinoma, which has potential value as a target of immunotherapy for bladder urothelial carcinoma.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.14

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