A Study Of Correlation Between CD28～+T Cell Value And Chemotherapy In Patients With Digestive Cancer

Recently,there was of attention to anti-tumor immunity in oncologic therapies,relationship of chemotherapy and immune function was becoming a new hotspot of study.There were many researches on influence of chemotherapy on T-lymphocyte subgroup and NK cells,especially CD3,CD4 and CD8 T cells,but there were few researches on CD28 T cell and B cell.At present, some research work has been done on the correlation between immunocyte and chemotherapeutic efficacy,considering that immune function is important,to evaluate efficacy in tumor patients.It's a pity.Deeper study isn't constantly made.During clinic work,we discovered a phenomenon that therapeutic effect in some patients with tumor related to the value of CD3~+CD28~+T cell.CD28 is one of the most important costimulators for T cell activation through binding with B7.Low expression of CD28 molecule is certain to influence B7-CD28 costimulatory pathway, interfere with activation and proliferation of T cells,so as to decrease cytokine secretion such as IL-2 and IFN.This results in escape immunosurveillance of tumor,and cuts down chemotherapeutic effect.This study was to analyze values and changes of CD28 T and B cells in peripheral blood of digestive cancer patients,explore the influence of chemotherapy on immune function in patients with digestive trace cancer and correlation between CD3~+CD28~+T cell and efficacy.(1)By flow cytometry,the absolute counts of CD3~+CD28~+,CTL,Ts and B cells in peripheral blood from 30 post-operation patients with digestive cancer were detected before and chemotherapy.According to statistical analysis,CD3~+CD28~+,CTL,B cell values in digestive cancer patients both pre-chemotherapy and post-chemotherapy were significantly lower than those of healthy people(P＜0.05).Comparing pre-chemotherapy with post-chemotherapy,no significant changes of CD3~+CD28~+,CTL,Ts and B cell value were observed.Before chemotherapy,negative correlation between the value of Ts and that of B cell were found(r=-0.366,P=0.047).But after chemotherapy,this correlation were not found(P=0.874).All these results indicated that chemotherapy doesn't seriously influence immune function of tumor patients,but can alter the negative correlation between Ts and B cell,so as to influence self-immunoregulatory function of tumor patients to some extent.(2)40 alimentary cancer patients with measurable tumor were included.10 healthy people were as control group.The absolute counts of CD3~+CD28~+T cell were measured with flow cytometry in these patients before chemotherapy.After all patients were received 2 cycles of chemotherapy,according to WHO standard,the chemotherapeutic efficacy was determined,40 patients were divided into three groups:CR+PR(complete response plus partial response),SD (stable disease)and PD(progressive disease).There was no significant difference in value of CD3~+CD28~+T cell between CR+PR group and control group(P=0.166).The value of CD3~+CD28~+T cell in SD group and PD group were lower than that in control group(P=0.001,P=0.000).CD3~+CD28~+T cell value in CR+PR group was higher than that in SD group and PD group(P=0.040,P=0.001),while in SD group was higher than in PD group (P=0.000).There was the relationship between effect of chemotherapy and CD3~+CD28~+T cell value,therapeutic effect better if the value of CD3~+CD28~+T cell in digestive cancer patients was higher before chemotherapy.There was better therapeutic effect if the value of CD3~+CD28~+T cell was near to that in healthy persons.Its efficacy worse,if CD3~+CD28~+T cell value in patients was less than that in healthy people.Therefore,the value of CD3~+CD28~+T cell is important for the early prediction of efficacy before chemotherapy.In conclusion,organic immune system has a higher self-regulated ability when affected by cytotoxic substance chemotherapy.It is probably the cause that immune function did not further decrease after chemotherapy.But chemotherapy can alter correlation between immunocyte,so as to influence self- immunoregulatory function of tumor patients.The value of CD3~+CD28~+T cell before chemotherapy may be used to primarily predict the chemotherapeutic effect of digestive cancer patients.Various factors can influence the chemotherapeutic effect,such as resistance and different histological types,indicators of predictable effect are also more than one.So CD28~+T cell value doesn't only reflect change of immune function after chemotherapy,but also can predict the effect to some extent.