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目的:检测鼻咽癌患者外周血中T细胞表面程序性死亡分子1(programmed death-1,PD-1)、刺激分子4-1BB的表达水平,探讨其在鼻咽癌中的临床意义。方法:选取2016年10至11月福建省肿瘤医院病理确诊的鼻咽癌患者30例作为研究对象,并选取同期本院体检中心性别、年龄相近的健康体检者30例作为对照组。通过流式细胞术检测外周血T细胞表面PD-1、4-1BB的表达情况以及T淋巴细胞亚群的比例。核磁共振扫描测量原发肿瘤体积。结果:鼻咽癌Ⅲ期患者外周血CD8+T细胞比例明显低于Ⅳ期患者[(13.1±6.2)%vs(18.7±5.5)%,P<0.05]。与对照组相比,CD4+T细胞上PD-1阳性表达率显著上调[(8.7±6.5)%vs(3.87±3.0)%,P<0.05]。鼻咽癌患者外周血T细胞PD-1、4-1BB分子表达水平与临床分期、肿瘤负荷、性别及年龄无显著相关(P>0.05)。结论:鼻咽癌患者外周血PD-1和4-1BB两种共刺激分子在患者体内肿瘤免疫逃逸中可能存在协同效应。联合干预这两种共刺激分子的信号通路可能具有更高效持久的抗肿瘤效应,可为鼻咽癌免疫治疗提供新的思路。
Objective: To detect the expression of programmed death-1 (PD-1) and 4-1BB on peripheral blood of patients with nasopharyngeal carcinoma (NPC) and to investigate its clinical significance in nasopharyngeal carcinoma. Methods: Thirty patients with nasopharyngeal carcinoma confirmed by pathology in Fujian Cancer Hospital from October to November 2016 were selected as the research objects. 30 healthy subjects of similar sex and age at the same period were selected as the control group. Flow cytometry was used to detect the expression of PD-1,4-1BB and the proportion of T lymphocyte subsets on peripheral blood T lymphocytes. Nuclear magnetic resonance scans measure primary tumor volume. Results: The proportion of CD8 + T cells in peripheral blood of patients with stage Ⅲ nasopharyngeal carcinoma was significantly lower than that of stage Ⅳ [(13.1 ± 6.2)% vs (18.7 ± 5.5)%, P <0.05]. Compared with the control group, the positive rate of PD-1 on CD4 + T cells was significantly up-regulated [(8.7 ± 6.5)% vs (3.87 ± 3.0)%, P <0.05]. The expression of PD-1, 4-1BB in peripheral blood T cells of patients with nasopharyngeal carcinoma was not significantly correlated with clinical stage, tumor burden, sex and age (P> 0.05). CONCLUSIONS: Two costimulatory molecules of PD-1 and 4-1BB in peripheral blood of patients with nasopharyngeal carcinoma may have synergistic effect in tumor immune escape in patients. Joint intervention of these two costimulatory molecules signaling pathway may have a more efficient and lasting anti-tumor effect, which may provide a new idea for the immunotherapy of nasopharyngeal carcinoma.