| Objective: Oral cancinomas are common malignant tumors, ranking sixth in the systemic malignant tumors (after the lung, stomach, breast, colorectal carcinoma and cervical carcinoma after), its incidence has increased year by year in recent years, more than 500,000 new cases each year, while China has a high incidence of oral carcinoma. Because of its special site morbidity, oral carcinoma influence the appearance and important physiological functions, the impact to the body and the psychological of the patients can not be ignored. Even though the current level of medical technology has made great imprvement, the treatment of oral carcinoma is still mainly based on surgery, supplemented by local radiotherapy and systemic chemotherapy combined, and comprehensive treatment is a one of the effective ways to the clinicalⅢ,Ⅳpatients to improve the efficacy. It has far-reaching practical significance in the study of immunotherapy based on the current comprehensive treatment for patients with oral cancinoma . T cells, an important part of the immune cells ,are the key of anti-tumor immunity. According to their different cell surface markers,T cells are divided into different subsets, such as CD4 ~+ T cells, CD8 ~+ T cells, and play different roles in the anti-tumor immunity . These cells are heterogeneous groups, may be further sub-divided into different categories, different subclasses of T lymphocytes play different roles, they can stimulate or inhibit anti-tumor immunity. In addition to killing tumor cells directly, T cells can also secret different types of cytokines such as INF-γ, IL-2, IL-4, to regulate the anti-tumor immune, and maintain the immune balance. In this study, monoclonal antibody technology and flow cytometry is applied to study the changes of the T lymphocyte subsets and intracellular Th1 type cytokine in peripheral blood in patients with oral cancinoma before and after surgery, paclitaxel plus cisplatin chemotherapy , then analyze the changes of the distribution and the function of T lymphocytes before and after clinical treatment, providing theoretical support to the immunotherapy for patients with oral cancer.Methods: Fresh blood pleasing 100μl, add FITC-CD3 monoclonal antibody 10μl, FITC labeled CD4 monoclonal antibody 10μl, PE labeled CD8 monoclonal antibody 10μl and PE labeled CD56 monoclonal antibody 10μl, PE labeled INF -γmonoclonal antibody 10μl, FITC labeled CD4 monoclonal antibody and PE labeled INF-γmonoclonal antibody 10μl seprately, PE labeled IL-2 monoclonal antibody 10μl, FITC labeled CD4 monoclonal antibody and PE labeled INF -γmonoclonal antibody 10μl seprately, incubated at room temperature for one dark hour, to add red blood cells with lysis buffer, lysis of RBC 5 minutes, add PBS solution hemoglobin washed and re-suspended in Medium 1ml PBS to flow cytometry T lymphocyte phenotype accounted for the percentage of total lymphocytes and T lymphocyte cells of INF-γ~+ and IL-2 ~+ T lymphocytes and the percentage of CD4 ~+, INF-γ~+ and CD4 ~+, IL-2 ~+ T lymphoid the proportion of cells and calculate the CD4 ~+ T cells / CD8 ~+ T cells ratio.Results: The CD3 ~+, CD4 ~+, CD8 ~+, CD56 ~+ T lymphocyte percentage a week after surgery were 62.75±8.20%, 42.77±6.33%, 25.55±5.45%, 15.78±8.84%, CD4 ~+ / CD8 ~+ ratio ranged from 1.60±0.42; CD3 expression is still lower than the control group (P <0.05), compared with the preoperative data showed that although small-scale improve, but by the statistical difference between the two was not significant (P> 0.05 ), CD4 expression was still lower than the normal control group, but compared with the preoperative upgrade larger (P <0.05), CD8 expression was significantly lower than the preoperative state, and the normal control group no significant differences, CD4 / CD8 ratio also has been picked up before, although its value has yet to be resumed to the level of healthy controls (P <0.05), CD56 expression with the preoperative and control group did not change significantly.20 days after paclitaxel plus cisplatin chemotherapy we determined the various surface markers of patients peripheral blood lymphocytes: CD3 ~+, CD4 ~+, CD8 ~+, CD56 ~+ T lymphocyte percentage were 64.13±10.38%, 38.44±10.88%, 26.35± 7.06%, 16.77±8.02%, CD4 ~+ / CD8 ~+ ratio ranged from 1.52±0.48; CD3 expression is similar to the patients of surgical group but still lower than the control group (P <0.05), and there was no significant difference (P> 0.05)with that before chemotherapy, CD4 expression is lower than the control group has some improvement, compared with that before chemotherapy. CD8 suppressor cell ratio dropped back to normal levels, is less than that before chemotherapy, CD4 / CD8 ratio increased, CD56 expression at this time there is no significant change.Surgery before and after the CD4 ~+ / INF-γ~+, CD4 ~+ / IL-2 ~+, INF-γ~+, IL-2 ~+ T lymphocyte, CD4 ~+ / INF-γ~+ + INF-γ~+ T, CD4 ~+ / IL-2 ~+ + IL-2 ~+ T lymphocyte ratio were 0.0480±0.0445%, 0.1145±0.0725%, 0.0765±0.0529%, 0.3410±0.1914%, 0.4700±0.0234%, 0.6500±0.0065% and 0.0945±0.0469%, 0.2190±0.1320%, 0.2680±0.3777% , 0.8760±0.8101%, 0.5140±0.0339%, 0.6500±0.0000%, There was no significant change (P> 0.05) between the group before and after surgery and normal control group in CD4~+/ INF-γ~+ T cells ratios, CD4~+/ IL-2~+, INF-γ~+, IL-2 ~+, CD4 ~+ / IL-2 ~++IL-2 ~+ T lymphocytes quantity before surgery were lower than the control group, and after the operation while the relative number of pick-up in all. Prompt in oral cancinoma patients before and after surgery there is a cytokine shift from Th2 to Th1 reversal, which is conducive to immune function in patients with oral cancer recovery.Compared to the patients of the surgical group, Th1 cytokines changes of preoperative chemotherapy group is not so clear, the CD4 ~+ / INF-γ~+, CD4 ~+ / IL-2 ~+, INF-γ~+, IL-2 ~+ T lymphocyte, CD4 ~+ / INF -γ~+ + INF-γ~+ T lymphocyte, CD4 ~+ / IL-2 ~+ + IL-2 ~+ T lymphocyte ratio were 0.0615±0.0594%, 0.1630±0.1908%, 0.1455±0.1148%, 0.4115±0.3711%, 0.4200±0.0259%, 0.4520±0.0136% and 0.0720±0.0658%, 0.1720±0.0978%, 0.2360±0.2732%, 0.4170±0.3752%, 0.5400±0.0205%, 0.6600±0.1038%, in the above data, except the ratoios of INF-γ~+, CD4 ~+ / IL-2 ~+ + IL-2 ~+ T lymphocytes has significantly improve, there is statistical significance, the others'proportion of T lymphocytes has no statistical significance, even though the data of the group after chemotherapy increases than the group before chemotherapy, suggesting that the patients with oral cancinoma treated by paclitaxel plus cisplatin chemotherapyhave a cytokine shift from Th2 to Th1 reversal, but not obvious.Conclusion: 1 There is an immune suppression in patients with oral carcinoma , the lymphocyte subtypes changed dramatically, supporting T cells reduced, and suppressor T-cell increased;2 Surgery and paclitaxel plus cisplatin chemotherapy can both improve immune status of the patients with oral carcinoma, and benefit the therapy of the carcinoma.3 The capacity of Th1 cytokine secretions changes in patients with oral carcinoma, surgery and chemotherapy also make corresponding changes to to the capacity, its specific mechanisms and more precise results need to be studied further.
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