| Objective CD4~+CD25~+ regulatory T cells(Treg) are a group of T cell subsets having the unique immune function, which are to account for 5-10% of human peripheral blood CD4~+T cells . Treg have an inhibitory effect of restraint or infliction on immune effector cells, through cell contact and (or)secretion of cytokines .The more Treg can restrain autoimmune diseases ,ease off inflammation and amplify the development of tumor promotion .The test is to probe into process of Treg and clinical value ,on the way of observing the change of CD4~+CD25~+ regulatory T cells(Treg) in patients with adbanced lung cancer treated by the intrapleural pingyangmycin administration.Methods In this clinical prospective study, since October 2009 to October 2010, patients who are diagnosed as lung cancers with MPE were recruited for the study .The patients were placed with the central venous catheter lumen closed chest tube after the chest B ultrasound, whose lung were confirmed to expand by X-ray lung recruitment or in 24 h pleural effusion drainage <150 ml .Then the pleural cavity of the patients were injected with 24mg of PYM ,after the patients were injected with drainage tube of lidocaine 5 minutes later .The three-color fluorescence labeling and direct multi-parameter flow cytometry are adopted to observe the changes of CD4~+CD25~+CD127- percentage of total (Treg) by the fixation of peripheral blood before and after 48h. SPSS 13.0 statistical software is used for all data processing ,and the result is indicated as mean±standard deviation (x~-±s). The paired t test is used to contrast significant differences of Treg ,and Pearson correlation analysis is adopted in Correlation analysis. P <0.05 is to be significant difference in the standard. Results 23 qualified patients were recruited, 17 males, 6 females, aged 64.57±11.80 years, of which 6 cases of squamous cell carcinoma, adenocarcinoma, and 12 cases were detected in pleural effusion cells, yet not clear cell pathology in 5 cases. After 4 weeks of treatment, effective in 14 cases, ineffective in 9 cases, so efficiency is 60.87%.There are 11 males and 3 females in effective group ,yet 6 males and 3 females in ineffective group .Two groups were of no difference in age, KPS score, Treg in the blood and pleural fluid before administration .The Treg after blood and pleural effusion of the treated patients were significantly lower than the preoperative (blood Treg: p = 0.019; pleural effusion Treg: p = 0.039).After administration Treg of blood decreased significantly (p = 0.010),yet Treg of pleural effusion reduced inconspicuous (p = 0.092);Treg of blood and pleural effusion in ineffective group reduced inconspicuous .Treg of blood was related with Treg of pleural effusion(r=0.528,r2=0.278, p=0.01) before treatment ,yet unallied (r=0.486,r2=0.237, p=0.019)after treatment. Treg of blood in effective group was related with Treg of pleural effusion(r=0.553,r2=0.306, p=0.04)before treatment ,yet unallied (r=0.320,r2=0.103, p=0.264)after treatment .Treg of blood was related with Treg of pleural effusion before and after treatment (pre-treatment r = 0.525, r2 = 0.275, p = 0.147, after treatment, r = 0.780, r2 = 0.608, p = 0.013).Conclusion PYM can control MPE effectively by administration into the pleural cavity,PYM can down regulate Treg in blood and pleural effusion ,The effect of PYM significantly reduced with the blood Treg, which can promoting inflammatory reaction. |
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