Cellular Immune Level Of Different Grades Of Cerebral Gliomas Patients Before And After Operation And Its Correlation With Postoperative Infection

Objective:To detect the changes of cellular immune level in patients with different grades of cerebral gliomas before and after operation and analyze the relationship between the malignant degree of glioma and the level of cellular immunity,and to explore the correlation between the change of cellular immune and the postoperative infections,which might provide the guidance for clinical judgement and prediction of infection.Methods:A total of 53 cases of brain tumor patients from Sept.2017 to Sept.2018 were analyzed,witch including 21 cases of low-grade group(WHO,grade Ⅰ~Ⅱ)and 32 cases of high-grade group(WHO,grade Ⅲ~Ⅳ).Fluorescence-activated cell sorting(FACS-Calibur)analysis was performed to detect the T lymphocyte subsets at the time of 1 day before operation,1 day and 7 day after operation,then detected its level in peripheral blood and analyze the difference between different grade gliomas.The relationship between immune level and infection was analyzed.SPSS22.0 statistical software was used to analyze the data.Results:The patients with high-grade glioma showed a lower ratio of CD8~+、CD4~+CD25~+Foxp3~+before and after operation(34.23±2.48、9.66±1.47 vs 30.16±3.75、6.30±1.29),and the value of CD3~+、CD4~+、CD4~+/CD8~+was higher than the low-grade group(54.09±4.25、31.93±3.08、0.93±1.06 vs 62.37±6.57、34.88±4.43、1.16±0.11)(p=0.00).Compared with the day before operation,the level of CD3~+、CD4~+、CD4~+/CD8~+in the 2 groups was decreased(high-grade group:54.09±4.25、31.93±3.08、0.93±1.06 vs 48.84±3.69、29.49±2.41、0.84±1.05;low-grade group:62.37±6.57、34.88±4.43、1.16±0.11 vs55.44±7.25、29.05±4.04、0.92±0.11),CD8~+、CD4~+CD25~+Foxp3~+was increased(high-grade group:34.23±2.48、9.66±1.47 vs 34.99±2.96、11.09±1.70;low-grade group:30.16±3.75、6.30±1.29 vs 31.66±3.13、7.95±1.67),at the time of 1 day after operation(p=0.00).Compared with the day before operation,the level of CD3~+、CD4~+、CD4~+/CD8~+in the 2 groups was increased(high-grade group:54.09±4.25、31.93±3.08、0.93±1.06 vs 59.45±3.74、33.59±2.66、1.05±1.07;low-grade group:62.37±6.57、34.88±4.43、1.16±0.11 vs 67.73±7.18、35.55±4.95、1.27±0.12),CD8~+、CD4~+CD25~+Foxp3~+was decreased(high-grade group:34.23±2.48、9.66±1.47 vs 31.99±1.97、7.45±1.48;low-grade group:30.16±3.75、6.30±1.29 vs 28.10±3.12、5.50±1.25),at the time of 7 day after operation(p=0.00).Among the 53 patients,8 cases had intracranial infection after operation,the infection rate was 15.09%.Age(χ~2=8.097,p=0.024),duration of surgery(χ~2=10.957,p=0.000),pathological stage(χ~2=11.716,p=0.001),and intraoperative blood transfusion(χ~2=15.375,p=0.000)constitute the independent risk factors of intracranial infection after operation of Gliomas.Conclusion:The cellular immune level was inhibited in patients with gliomas,the inhibition degree in the high-grade patients was more significantly than those had low-grade.The level of the CD4~+CD25~+Foxp3~+regulatory T cells was obviously reduced after the operation,and the inhibition degree of the cellular immunity was relieved.Which suggests that the T lymphocyte subsets could be considered as an evaluating index of the glioma malignancy and the prognosis in patients with glioma.In is of clinical positive significance to emphasize the clinical detecting of cellular immune in predict and prevent the postoperative intracranial infection in patients with glioma.