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目的检测围手术期尿路上皮癌患者外周血的CD3+、CD4+、CD8+T淋巴细胞比例和人类巨细胞病毒(HCMV)IgG和IgM抗体,了解近期HCMV感染对围手术期尿路上皮癌患者细胞免疫功能的影响。方法采集33例经病理检测确诊为尿路上皮癌的患者外周血,流式细胞仪检测外周血CD3+、CD4+和CD8+T细胞亚群比例,血浆ELISA法定性检测HCMV-IgG和HCMV-IgM抗体,根据HCMV-IgM抗体结果将尿路上皮癌患者分为阳性组和阴性组,比较两组患者的T细胞亚群有无差异。结果 33例患者中HCMV-IgG抗体阳性31例;HCMV-IgM抗体阳性7例,阴性26例。HCMV-IgM阳性组和阴性组之间的CD3+、CD4+和CD8+T细胞亚群有着显著的差异(P<0.01)。阳性组患者的CD4+T细胞的百分比显著低于阴性组,并且该组CD4+/CD8+比值亦显著低于阴性组。CD4+/CD8+的比值提示阳性组中有85%(6/7)的患者处于免疫功能低下状态,而相对于阴性组仅有11.5%(3/23)的患者处于免疫功能低下状态,两组间差异有统计学意义(P<0.01)。结论术前检测HCMV-IgM可以很好地预测尿路上皮癌患者的细胞免疫功能,对术后辅助治疗具有指导意义。
Objective To detect perioperative urothelial carcinoma patients with peripheral blood CD3 +, CD4 +, CD8 + T lymphocyte ratio and human cytomegalovirus (HCMV) IgG and IgM antibodies to understand the recent HCMV infection in perioperative patients with urothelial carcinoma cells Impact of immune function. Methods Peripheral blood samples of 33 patients diagnosed as urothelial carcinoma by pathology were collected. The proportions of CD3 +, CD4 + and CD8 + T cell subsets in peripheral blood were determined by flow cytometry. The plasma samples were detected by ELISA for detection of HCMV-IgG and HCMV-IgM antibodies According to the result of HCMV-IgM antibody, the patients with urothelial carcinoma were divided into positive group and negative group. The difference of T cell subsets between the two groups was compared. Results Of the 33 patients, 31 were HCMV-IgG positive, 7 were HCMV-IgM positive and 26 were negative. There were significant differences in CD3 +, CD4 + and CD8 + T cell subsets between HCMV-IgM positive and negative groups (P <0.01). The percentage of CD4 + T cells in the positive group was significantly lower than that in the negative group, and the ratio of CD4 + / CD8 + in the positive group was significantly lower than that in the negative group. The CD4 + / CD8 + ratio suggested that 85% (6/7) of patients in the positive group were immunocompromised and only 11.5% (3/23) of patients in the negative group were immunocompromised, The difference was statistically significant (P <0.01). Conclusion Preoperative detection of HCMV-IgM can be a good predictor of cellular immune function in patients with urothelial carcinoma, postoperative adjuvant therapy is instructive.