前列腺癌患者免疫功能状态的初步研究

发布时间：2018-08-30 11:10

【摘要】：目的：通过对前列腺癌(Prostate Cancer, PCa)患者多项免疫指标的检测,初步评估前列腺癌患者的免疫功能状态,探讨前列腺癌患者免疫功能状态与前列腺癌临床分期、病理分级、内分泌治疗等临床因素的关系。方法：分别选取前列腺癌患者28例,前列腺增生(Benign Prostatic Hyperplasia, BPH)患者16例,健康对照者10例,采集其新鲜外周血,使用流式细胞术检测外周血CD4+、CD8+和NK细胞的百分率以及CD4+/CD8+的比值。另选取前列腺癌患者30例,前列腺增生患者17例,健康对照者(healthy men, HM)7例,采集其新鲜外周血并提取外周血淋巴细胞(peripheral blood lymphocyte, PBL),运用运用实时荧光定量PCR (Real-Time PCR)检测受试者PBL中perforin、 granzyme-B的mRNA的表达水平,并进行统计学分析,观察各组免疫指标的差异,评价各项免疫指标的变化与前列腺癌临床分期、病理分级等临床变量之间的关系。结果：前列腺癌组患者CD4+淋巴细胞百分比及CD4+/CD8+的比值较前列腺增生组及健康对照组显著降低且差异有统计学意义(P0.05)；CD8+淋巴细胞百分比较其他两组升高,差异有统计学意义(P0.05)；NK细胞百分比较前列腺增生组及健康对照组差异无统计学意义(P0.05)。高分化前列腺癌CD4+淋巴细胞百分比及CD4+/CD8+的比值高于中、低分化前列腺癌,CD8+淋巴细胞百分比低于低分化前列腺癌,差异均有统计学意义(P0.05),二者NK细胞百分比差异无统计学意义(P0.05)。T3期前列腺癌与T4期前列腺癌相比,CD4+/CD8+淋巴细胞百分比、CD4+/CD8+的比值及NK细胞百分比差异均无统计学意义(P0.05)。无转移前列腺癌CD4+淋巴细胞百分比及CD4+/CD8+的比值较有转移前列腺癌明显升高,差异有统计学意义(P0.05),CD8+淋巴细胞百分比低于有转移前列腺癌且差异有统计学意义(P0.05),两者NK细胞百分比差异无统计学意义(P0.05)。未行内分泌治疗前列腺癌与内分泌治疗时程4周前列腺癌相比,CD4+/CD8+、NK细胞百分比及CD4+/CD8+比值间的差异无统计学意义(P0.05)。前列腺癌组患者perforin、granzyme-B mRNA相对表达量均显著低于前列腺增生组及健康对照组,且差异有统计学意义(P0.05)。高分化前列腺癌perforin、granzyme-B mRNA相对表达量均高于中、低分化前列腺癌,差异有统计学意义(P0.05)。T3期前列腺癌perforin、granzyme-B mRNA相对表达量均高于T4期前列腺癌,差异有统计学意义(P0.05)。无转移前列腺癌与有转移前列腺癌相比,perforin、granzyme-B mRNA相对表达水平差异无统计学意义(P0.05)。未行内分泌治疗前列腺癌与内分泌治疗时程4周前列腺癌相比,perforin、granzyme-B mRNA相对表达水平差异无统计学意义。结论：1.前列癌患者较前列腺增生患者和健康者机体免疫力降低。2.前列腺癌患者免疫抑制程度可能与肿瘤恶性程度和临床进展程度相关,恶性程度越高、临床分期越晚提示前列腺癌患者免疫抑制程度越重。3.内分泌治疗对前列腺癌患者的免疫功能无显著影响。
[Abstract]:Objective: to evaluate the immune function of prostate cancer patients with (Prostate Cancer, PCa), and to explore the clinical stage and pathological grade of prostate cancer. The relationship between endocrine therapy and other clinical factors. Methods: 28 cases of prostate cancer, 16 cases of benign prostatic hyperplasia (Benign Prostatic Hyperplasia, BPH) and 10 cases of healthy control were collected from fresh peripheral blood. The percentage of CD4 CD8 and NK cells and the ratio of CD4 / CD8 in peripheral blood were detected by flow cytometry. In addition, 30 patients with prostate cancer, 17 patients with benign prostatic hyperplasia and 7 healthy people with (healthy men, HM) were selected. The expression of perforin, granzyme-B mRNA in PBL was detected by real-time fluorescence quantitative PCR (Real-Time PCR), and the expression of perforin, granzyme-B mRNA was analyzed statistically. To evaluate the relationship between the changes of immune indexes and clinical variables such as clinical stage and pathological grade of prostate cancer. Results: the percentage of CD4 lymphocyte and the ratio of CD4 / CD8 in prostate cancer group were significantly lower than those in benign prostatic hyperplasia group and healthy control group (P0.05). The difference was statistically significant (P0.05) the percentage of NK cells was not significantly higher than that of benign prostatic hyperplasia group and healthy control group (P0.05). The percentage of CD4 lymphocytes and the ratio of CD4 / CD8 in well-differentiated prostate cancer were higher than those in low-differentiated prostate cancer, and the percentage of CD8 lymphocytes in poorly differentiated prostate cancer was lower than that in poorly differentiated prostate cancer. There was no significant difference in the percentage of NK cells between the two groups (P0.05). There was no significant difference in the percentage of CD4 / CD8 lymphocytes and the percentage of NK cells between stage T3 prostate cancer and T4 stage prostate cancer (P0.05). The percentage of CD4 lymphocytes and the ratio of CD4 / CD8 in non-metastatic prostate cancer were significantly higher than those in metastatic prostate cancer. The percentage of CD8 lymphocytes was significantly lower than that of metastatic prostate cancer (P0.05), but there was no significant difference in the percentage of NK cells between the two groups (P0.05). There was no significant difference in the percentage of CD4 / CD8 NK cells and the ratio of CD4 / CD8 between prostate cancer without endocrine therapy and prostate cancer after 4 weeks of endocrine therapy (P0.05). The relative expression of perforin,granzyme-B mRNA in prostate cancer group was significantly lower than that in benign prostatic hyperplasia group and healthy control group (P0.05). The relative expression of perforin,granzyme-B mRNA in well-differentiated prostate cancer was higher than that in low-differentiated prostate cancer, the difference was statistically significant (P0.05). The relative expression of perforin,granzyme-B mRNA in stage T3 prostate cancer was higher than that in stage T4 prostate cancer, and the difference was statistically significant (P0.05). There was no significant difference in the relative expression of perforin granzyme-B mRNA between non-metastatic prostate cancer and metastatic prostate cancer (P0.05). There was no significant difference in the relative expression of granzyme-B mRNA between prostatic cancer without endocrine therapy and prostate cancer treated with endocrine therapy for 4 weeks. Conclusion 1. The immunity of prostatic cancer patients was lower than that of benign prostatic hyperplasia patients and healthy people. The degree of immunosuppression in patients with prostate cancer may be related to the degree of malignancy and clinical progression. The higher the degree of malignancy, the later the clinical stage indicates that the degree of immunosuppression in patients with prostate cancer is more serious. 3. Endocrine therapy had no significant effect on immune function of prostate cancer patients.
【学位授予单位】：中南大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.25

【共引文献】