【摘要】目的:探讨鼻咽癌患者外周血淋巴细胞亚群和NK细胞活性与治疗前后EB病毒IgA/VCA抗体水平高低、是否转移及不同临床分期的关系及其意义。方法:采用流式细胞术(FCM)检测58例鼻咽癌患者治疗前后外周血淋巴细胞亚群和NK细胞的百分含量。结果:①鼻咽癌患者治疗后和治疗前比较,CD8+细胞水平显著升高,CD4+和CD19+细胞水平和 CD4+/CD8+的比值显著下降,差异有统计学意义(P<0.05),CD3+的差异无统计学意义(P>0.05);②EB病毒IgA/VCA抗体高滴度和低滴度的鼻咽癌患者比较,在治疗前,NK细胞和CD19+细胞水平显著升高,差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05);在治疗后,各项指标差异无统计学意义(P>0.05);③有淋巴结转移和无淋巴结转移的鼻咽癌患者比较,在治疗前,NK细胞和CD19+细胞水平显著升高,差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05);在治疗后,各项指标差异无统计学意义(P>0.05);④Ⅲ~Ⅳ期和Ⅰ~Ⅱ期的鼻咽癌患者比较,在治疗前,CD19+细胞水平显著升高,差异有统计学意义(P<0.05),其余指标差异无统计学意义(P>0.05);在治疗后,各项指标差异无统计学意义(P>0.05)。结论:鼻咽癌患者机体细胞免疫状态与机体是否存在局部淋巴结和远处转移无明显相关性,但在进行治疗后机体细胞免疫抑制状态较治疗前明显改善。
【Abstract】 Objective To explore lymphocyte subsets and NK cells activity in peripheral blood of nasopharyngeal carcinoma patients, and their relations with the IgA/VCA antibody level against EB virus before and after treatment, lymph node metastasis, and clinical stage. Method Flow cytometry (FCM) was used to detect peripheral blood lymphocyte subsets and NK cells percentage of 58 patients with nasopharyngeal carcinoma before and after treatment. Results (1)After treatment, CD8+cells were significantly increased, CD4+ and CD19+ cells and CD4+/CD8+ ratio were decreased significantly, the differences were statistically significant (P<0.05), the change of CD3+ cell showed no statistical significance (P>0.05); (2) Before treatment, the level of CD19+ NK cell in those with the high titer of EB virus IgA/VCA antibody was higher than that of those with the low titer (P<0.05), the rest of the index had no significant difference (P>0.05). After treatment, there were no significant differences in these indicators (P>0.05); (3) Between those with lymph node metastasis and without lymph node metastasis before treatment, the CD19+ NK cell level of the former was significantly increased (P<0.05), the rest of the index difference had no statistical significance (P>0.05). There was no statistically significant difference after treatment (P>0.05); (4) The CD19+ cell level of cases on the Ⅲ-Ⅳ stage was higher than that of those on the Ⅰ-Ⅱ stage before treatment (P<0.05), the rest of the index difference has no statistical significance (P>0.05). There were no statistically significant differences in the indicators after treatment, (P>0.05). Conclusion There is no evidence of a correlation between the state of the organism cellular immunity in patients with nasopharyngeal carcinoma (NPC) and local lymph node or distant metastasis, and cellmediated immunity can be significantly improved after treatment.