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目的观察手术前后乳腺癌患者体内辅助性T淋巴细胞(helper T lymphocyte,Th)1、2型细胞因子的表达及意义。方法 2009年11月2010年12月,采用酶联免疫吸附试验检测40例乳腺癌患者(乳腺癌组)手术前、后和15例健康妇女(正常对照组)外周血单个核细胞培养上清液中Thl型细胞因子[白细胞介素(interleukin,IL)-2、干扰素(interferon,IFN)-γ]和Th2型细胞因子(IL-4、IL-6)表达水平。结果乳腺癌组术前外周血IL-2、IFN-γ、IL-4和IL-6的检测结果在分别为(326.5±67.4)、(288.5±35.6)、(41.2±10.8)、(526.1±136.4)ng/L,手术后分别为(958.1±284.7)、(559.6±106.9)、(26.1±8.7)、(395.6±125.9)ng/L;在正常对照组分别为(1 498.0±325.9)、(784.6±126.3)、(16.6±3.7)、(297.4±83.7)ng/L。与正常对照组相比,术前乳腺癌患者外周血Th1型细胞因子表达降低,Th2型细胞因子表达升高,差异有统计学意义(P<0.05);与术前相比,乳腺癌患者术后Thl型细胞因子表达升高,Th2型细胞因子表达降低,差异有统计学意义(P<0.05)。结论①乳腺癌患者Th细胞呈现Th1抑制和Th2极化状态,细胞免疫受抑制。②手术切除肿瘤可在早期一定程度上逆转Th1/Th2的失衡状态,改善机体免疫状态,对预后产生积极作用。
Objective To observe the expression and significance of helper T lymphocyte (Th) 1,2 and cytokines in breast cancer patients before and after operation. Methods In November 2010 and December 2010, 40 patients with breast cancer (breast cancer group) and 15 healthy women (normal control group) were enrolled in this study. Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of peripheral blood mononuclear cell culture supernatant Thl-type cytokines [interleukin (IL) -2, interferon (IFN) -γ] and Th2-type cytokines (IL-4, IL-6) Results The preoperative serum levels of IL-2, IFN-γ, IL-4 and IL-6 in breast cancer patients were 326.5 ± 67.4, 288.5 ± 35.6, 41.2 ± 10.8, 526.1 ± 136.4 ng / L, respectively, and were 958.1 ± 284.7, 559.6 ± 106.9, 26.1 ± 8.7, 395.6 ± 125.9 ng / L respectively after surgery; in the normal control group, they were (1 498.0 ± 325.9) (784.6 ± 126.3), (16.6 ± 3.7) and (297.4 ± 83.7) ng / L, respectively. Compared with the normal control group, the expression of Th1-type cytokines and Th2-type cytokines in the peripheral blood of preoperative breast cancer patients were significantly lower than those of the normal control group (P <0.05) After Thl type cytokines increased, Th2 type cytokines decreased, the difference was statistically significant (P <0.05). Conclusion ① Th cells in patients with breast cancer showed Th1 inhibition and Th2 polarization, and cellular immunity was inhibited. ② Surgical resection of the tumor can reverse the imbalance of Th1 / Th2 to a certain extent in the early stage, improve the immune status and have a positive effect on the prognosis.