围术期异体输血对胃癌患者Th17/Treg失衡的影响

摘要

目的 探讨围术期异体输血对胃癌患者辅助性T淋巴细胞17(Th17)和调节性T细胞(Treg)失衡的影响.方法 选择行胃癌根治术的57例患者作为胃癌组,根据围术期是否输血,再将胃癌组患者分为未输血组26例和输血组31例;另选择健康体检者20例作为对照组.采用流式细胞术(FCM)检测对照组和胃癌组术前及术后1 d、7 d、14 d外周血中Th17细胞、Treg细胞比例及Th17/Treg比值.结果 胃癌组患者Th17细胞、Treg细胞比例及Th17/Treg比值均明显高于对照组(P均<0.05);术后14 d,输血组Th17细胞、Treg细胞比例均明显高于未输血组(P均<0.05),Th17/Treg比值明显低于未输血组(P<0.05);未输血组Th17细胞、Treg细胞比例及Th17/Treg比值与术前比较差异均无统计学意义(P均>0.05).结论 胃癌患者存在Th17/Treg失衡;围术期异体输血可能通过调节Th17、Treg免疫细胞表达导致Th17/Treg失衡加剧,影响胃癌患者的细胞免疫状态.%Objective It is to investigate the effect of perioperative allogeneic blood transfusion on the imbalance of helper T lymphocyte 17 (Th17) and regulatory T cell (Treg) in gastric cancer patients. Methods Fifty-seven patients who underwent radical gastrectomy were selected as gastric cancer group, then the gastric cancer patients were divided into the non transfusion group (26 cases) and the transfusion group (31 cases) according to the perioperative blood transfusion;and 20 cases of health examiner were selected as the control group. The proportion of Th17 cells, Treg cells and Th17/Treg ratio was detected by Flow cytometry ( FCM) in peripheral blood of control group and gastric cancer group before and after operation of 1, 7 and 14 days. Results The proportion of Th17 cells, Treg cells and Th17/Treg ratio in the gastric cancer group were significantly higher than those in the control group (all P<0. 05). After operation of 14 days, the proportion of Th17 cells and Treg cells in the transfusion group was significantly higher than that in the non transfusion group ( all P<0. 05), and the Th17/Treg ratio was significantly lower than that in the non transfusion group (P<0. 05); there was no significant difference in the proportion of Th17 cell, Treg cell and Th17/Treg ratio compared with before operation in the non transfusion group (all P>0. 05). Conclusion There is Th17/Treg imbalance in the patients with gastric cancer. Peri-operative allogeneic blood transfusion may aggravate the imbalance of Th17/Treg by regulating the expression of Th17 and Treg immune cells, and affect the cell immune state of the patients with gastric cancer.