Clinical Significance Of Level Of CD4⁺CD25^HiCD127^lo Regulatory T Cells In The Peripheral Blood Of Patients With Esophageal Cancers

Objective: This study aimed to observe the differences in the levels of of CD4+CD25HiCD127lo regulatory T cells (Treg, CD25Hi and CD127lo represent high expression of CD25 and low expression of CD127 respectively) and the other related immunocyte subsets in the peripheral blood, and IL-10 and TGF-β1 in plasma between the healthy humans and the patients with esophageal cancer. Then, to investigate the relationship of these differences with the clinical pathological conditions and the responding clinical significances .Methods: The levels of Treg and the other related immunocyte subsets in the peripheral blood, and IL-10 and TGF-β1 in plasma, in 20 healthy subjects and 80 patients with esophageal cancer, were detected by FCM and ELISA. Among these patients, the levels of these markers in 30 subjects were also detected at the eleventh day after operation. In addition, the informations of the clinical and pathological conditions were collected, and the correlation were anyalzed with the above markers.Results: 1. The patients with esophageal cancer, compared with the healthy subjects, had a significantly higher levels of Treg (5.70±1.96% and 3.36±1.14%, respectively, P<0.01) and the levels of CD8+T cells (30.54±8.58% and 24.85±4.63%, respectively, P<0.05) in the peripheral blood, and the plasma TGF-β1 levels (236.74±70.65 pg/ml and 124.31±86.82 pg/ml, P<0.05). In contrast, the levels of CD4+T cells (30.03±7.50%, P<0.05) and the ratio of CD4+/CD8+ (1.03±0.25%, P<0.05) in the peripheral blood were significantly lower than those in the healthy subjects (35.60±6.14% for CD4+T cells and 1.48±0.34% for the ratio of CD4+/CD8+).2. The levels of Treg in the peripheral blood was significantly higher in the patients with metastasis of lymph node than that in the patients without metastasis of lymph node [5.96±1.36% (n=40) and 4.23±1.18% (n=30), respectively, P<0.05]. Furthermore, The levels of IL-10 (26.25±3.41 ng/ml, P<0.05) and TGF-β1 (246.10±45.70 pg/ml, P<0.05) in plasma in the patients was significantly higher than that in the patients without metastasis of lymph node (22.18±4.80 ng/ml and 186.33±54.09 pg/ml, respectively).3. The levels of Treg in the peripheral blood were significantly correlated with the TNM classification in the patients with esophageal cancer (r=0.770, P<0.05). The advanced TNM classification increased the levels of Treg in the peripheral blood. Nonetheless, the levels of plasma IL-10 and TGF-β1 in the patients were positively correlated with the TNM classification(r=0.573 and 0.728, respectively, P<0.05). As the TNM classification advanced, the level of the Treg and plasma IL-10 and plasma TGF-β1 in the peripheral blood was increased. 4. The preoperative levels of plasma TGF-β1 (210.17±56.38 pg/ml) was significantly higher than those postoperative levels [193.27±47.12(n=30)](P<0.05). The ratio of CD4+/CD8+ significantly decreased from 1.31±0.37% to 1.04±0.26% after operation (P<0.05).5. The level of IL-10 was correlated with percentage of Treg inⅢ,Ⅳpatients with esophageal cancer(r=0.718,P<0.01) ,whereas The level of TGF-β1 was correlated with percentage of Treg in both the stageⅠ,Ⅱand stageⅢ,Ⅳpatients with esophageal cancer(r=0.645,P<0.01).Conclusion:1. The levels of Treg and plasma TGF-β1 in the peripheral blood of the patients with esophageal cancer were significantly higher than those of the healthy subjects, and were correlated with the clinical and pathological conditions. It is suggested that the development of esophageal cancer may relate with the suppression of immune function.2. The levels of Treg in the peripheral blood were positively correlated with that of plasma TGF-β1 and also positively correlated with that of IL-10 in the later stage of patients with esophageal cancer , which implied that the Treg may inhibit the immune function by directly or indirectly regulation of the secretion of IL-10 and TGF-β1 in patients with esophageal cancer.3. The patients with esophageal cancer had significantly higher levels of Treg and CD8+T cells in the peripheral blood and plasma TGF-β1, and a significantly lower level of CD4+T cells in the peripheral blood than the healthy subjects. If the levels of these immune cells and cytokines were combined detected, that may reflect the cellular immune function more accurately.