Analyis The Main Impact Factors Of Immune Status In Women With Breast Cancer

Worldwide, breast cancer accounts for 10% of all cancer incidence, Breast cancer is one of the most common malignant tumor of female, it has become the greatest threat of the physical and mental health for younger women. In developed countries,most patients with breast cancer are older women after menopause, while more than half breast cancer patients in our country are premenopausal young women. And its morbidity and mortality has distinction in different country and area. In China, is showing a rising trend in recent years.Cellular immunity has a more important role in antitumor immune mechanism, T cell subsets are the important examination for cellular immune response.According to T cell surface CD antigen expression and function, it can be divided into CD4+T cells and CD8+T cells. The quantity and function of T cell subsets will influence on the development and prognosis of tumor when an exception occurs.Under normal circumstances, between immune cells and T cell subsets in our body had a normal order, keep the balance of the body's immune status.And whenCD4/CD8 ratio,and immune cell such as NK cell decreases,indicating that the body's immune function in patients are inhibited.Purpose:To investigate the main factors of the immune status in patients with breast cancer.Comparing the difference of immune status between normal and the patients.To explore the T cell subsets distribution between different clinical features of patients and the change of T cell funtions when patients suffer chemotherapyMethods:the samples of the peripheral blood of 70 patients with breast cancer in the second affiliated hospital of dalian medical university governance from January 2012 to June 2012 were collected on the day before postoperative adjuvant chemotherapy. The proportions of T cell subsets, NK cells were evaluated by flow cytometry.Collecting their age clinical characteristics:Ki67, TNM stage, molecular classification (ER, PR,Her-2), and lymphatic metastasis, compared with 30 cases of normal persons (control group).Results:Compared with control group, patients with breast cancer CD4 T cells and CD4/CD8 ratio decreased, while CD8 T cells increased (P< 0.05).T cell subsets distribution affected by clinical features in breast cancer patients:Compare to non Lumina, Lumina CD3(66.93±9.30 vs 72.30±6.67),CD8 (28.73±8.98 vs35.01± 8.44), CD4/CD8 ratio(1.44±0.58 vs 1.12±0.42),P<0.05. No lymph node metastasis VS lymph node metastasis CD4 (39.41±7.55 vs 33.88±8.61), CD4/CD8 ratio(1.50 ±0.56 vs 1.23±0.53), compared with lymph node metastasis group, CD4 and CD4/CD8 ratio decreased significantly, the difference was statistically significant. Ki67 had influence to the CD4/CD8 ratio, high proliferation group(1.19±0.53) vs low proliferation group (1.47±0.57), the difference was proved to be significant. Age only have an effect on CD3 value:elderly group (65.54±8.89) significantly lower than young group (70.93±8.26). Eventually, TNM stage has no influence on the distribution of T cell subsets. To further study, after chemotherapy, the proportion of CD3, CD8, NK cell significantly increase,CD4/CD8 ratio(1.11±0.48) is lower than(1.36±0.56), the difference was proved to be significant.And found that the rise of CD3,CD8 in (anthracycline-based combined paclitaxel)drug group was sharper than the (anthracycline) regime in stratified analysis.But NK cells has a big difference between regime groups:rising in the combined group, while falling in the single drug group. To study the T cell subsets distribution trends on every cycle of AC-T regime:CD3, CD4 is inverted U,CD8 show clear ascendant trend eventually leveled off.NK cells has fluctuation type change.Conclusion:Compared with control group, patients with breast cancer the immune status decreased. Different clinical features in patients with early breast cancer,there are differences between the distribution of T cell subgroup, but had no obvious effect on NK cell:these molecular classification, lymph node metastasis and Ki67 associated with T cell subgroup, the distribution of age and stage had no significant effect on T cell subgroup.Postoperative adjuvant chemotherapy of breast cancer made immune function decline.Different chemotherapy drugs and chemotherapy cycle of T cell subgroup had differences.The selection of chemotherapy drugs are the important factors which affect patients' immune status.Monitoring the expression of T cell subsets and NK cells in patients with level can reflect cellular immune state.To know different period of the immune function provide important clues and basis for tumor etiology, development process and clinical evaluation.