本文選題：肺癌　切入點(diǎn)：外周血　出處：《河北醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目前,肺癌已成為全球常見惡性腫瘤之一且生存率低,雖采用手術(shù)、化療、放療等方式進(jìn)行治療,依然無法顯著降低肺癌死亡率。隨著分子生物學(xué)和免疫技術(shù)的飛速發(fā)展,為肺癌的免疫治療提供了更充足的理論基礎(chǔ)和實(shí)踐經(jīng)驗(yàn)。免疫治療在肺癌的綜合治療中發(fā)揮著越來越顯著的作用,有望成為治愈肺癌的方法之一。免疫應(yīng)答是一個系統(tǒng)、連續(xù)而復(fù)雜的過程,隨著人們對免疫調(diào)節(jié)機(jī)制的深入研究,細(xì)胞因子在抗腫瘤免疫反應(yīng)中的重要作用逐漸被重視,細(xì)胞因子及分泌細(xì)胞因子的淋巴細(xì)胞的研究將成為腫瘤生物治療領(lǐng)域的研究熱點(diǎn),應(yīng)用前景良好。腫瘤細(xì)胞打破局部及外周血中免疫細(xì)胞、細(xì)胞因子之間的平衡。近來新型輔助性T細(xì)胞-Th17被識別,以分泌IL-17為特點(diǎn),介導(dǎo)炎癥反應(yīng)和自身免疫性疾病等的發(fā)展。目的:應(yīng)用流式細(xì)胞微球陣列術(shù)(CBA)檢測肺癌患者外周血中Th1、Th2、Th17多個細(xì)胞因子的表達(dá)水平,探討細(xì)胞因子的改變在肺癌外周血免疫微環(huán)境中的表達(dá)及其臨床意義。方法:1研究對象篩選在河北大學(xué)附屬醫(yī)院住院治療病人中選取確診的肺癌患者50例作為實(shí)驗(yàn)組,健康體檢者為對照組。對照組患者無合并其他疾病。2血清樣本收集實(shí)驗(yàn)組患者分別于化療前和2周期化療后采血,清晨分別抽取兩組患者空腹外周血5 ml,對照組于清晨空腹采取外周血5ml,分別離心取上清,作好標(biāo)記。3效應(yīng)因子檢測應(yīng)用流式細(xì)胞微球陣列術(shù)試劑盒分別檢測外周血中Th1(TNF-α、IFN-γ、IL-2)、Th2(IL-4、IL-6、IL-10)、Th17(IL-17)細(xì)胞因子濃度。結(jié)果:1化療前實(shí)驗(yàn)組和對照組細(xì)胞因子變化和對照組相比,化療前實(shí)驗(yàn)組細(xì)胞因子Th2(IL-4、IL-6、IL-10)、Th17(IL-17)等的水平顯著升高(P0.05),而Th1(TNF-α、IFN-γ、IL-2)水平顯著降低(P0.05)。2化療前和化療后細(xì)胞因子變化和化療前相比,化療后實(shí)驗(yàn)組細(xì)胞因子Th2(IL-4)、Th17(IL-17)等的水平顯著降低(P0.05),Th2(IL-6、IL-10)有下降趨勢,但無統(tǒng)計(jì)學(xué)差異(P0.05);Th1(TNF-α、IFN-γ、IL-2)水平顯著升高(P0.05)。3化療后實(shí)驗(yàn)組和對照組和對照組相比,化療后實(shí)驗(yàn)組細(xì)胞因子Th2(IL-4、IL-6、IL-10)、Th17(IL-17)等的水平顯著升高(P0.05),Th1(TNF-α、IFN-γ、IL-2)水平顯著降低(P0.05)。但是化療前細(xì)胞因子變化幅度水平減小。4在健康人群中,IL-17與Th1和Th2型細(xì)胞因子之間無明顯相關(guān)性(P0.05);在肺癌患者中IL-17與Th1型細(xì)胞因子IFN-γ、IL-2和Th2型細(xì)胞因子IL-6、IL-10顯著相關(guān)(P0.05);結(jié)論:1肺癌患者外周血中Th1型細(xì)胞因子下降、Th2、Th17型細(xì)胞因子上調(diào),提示這可能是肺癌免疫功能下降的原因,與肺癌發(fā)生、發(fā)展有關(guān)。2化療有效后有可能改善肺癌患者免疫功能。
[Abstract]:At present, lung cancer has become one of the most common malignant tumors in the world and the survival rate is low. Although surgery, chemotherapy, radiotherapy and other methods are used to treat lung cancer, the mortality rate of lung cancer can not be significantly reduced.With the rapid development of molecular biology and immune technology, it provides more theoretical basis and practical experience for immunotherapy of lung cancer.Immunotherapy plays a more and more important role in the comprehensive treatment of lung cancer and is expected to be one of the methods to cure lung cancer.Immune response is a systematic, continuous and complex process. With the in-depth study of immunomodulatory mechanism, the important role of cytokines in anti-tumor immune response has been paid more and more attention.The study of cytokines and cytokine secreting lymphocytes will become a hot topic in the field of tumor biotherapy.Tumor cells break the balance between immune cells and cytokines in local and peripheral blood.Recently, novel helper T cells-Th17 have been recognized, characterized by the secretion of IL-17, mediating inflammatory response and autoimmune diseases.Objective: to detect the expression of more than Th1 Th2Th17 cytokines in peripheral blood of lung cancer patients by flow cytometry microsphere array (CBA), and to investigate the expression of cytokines in peripheral blood immune microenvironment of lung cancer and its clinical significance.Methods Twenty one subjects were selected from the hospitalized patients in affiliated Hospital of Hebei University. 50 patients with lung cancer were selected as the experimental group and the healthy persons as the control group.The control group had no other diseases. 2 serum samples were collected from the patients in the experimental group before and after 2 cycles of chemotherapy.In the morning, the fasting peripheral blood of the two groups were drawn from 5 ml, while the control group took 5 ml of peripheral blood on an empty stomach in the morning, and centrifuged the supernatant respectively.緇撴灉:1鍖栫枟鍓嶅疄楠岀粍鍜屽鐓х粍緇嗚優(yōu)鍥犲瓙鍙樺寲鍜屽鐓х粍鐩告瘮,鍖栫枟鍓嶅疄楠岀粍緇嗚優(yōu)鍥犲瓙Th2(IL-4,IL-6,IL-10),Th17(IL-17)絳夌殑姘村鉤鏄捐憲鍗囬珮(P0.05),鑰孴h1(TNF-偽,IFN-緯,IL-2)姘村鉤鏄捐憲闄嶄綆(P0.05).2鍖栫枟鍓嶅拰鍖栫枟鍚庣粏鑳?yōu)鍥犲瓙鍙樺寲鍜屽寲鐤楀墠鐩告?

本文編號：1707225